Close exam of the injury reveals a significant burn component, instead of an abrasion-type injury. These linear burn marks are very suspicious for non-accidental injuries. The injuries in and of themselves are not diagnostic of abuse, however they can be used to compare with the step-mother's explanation and corroborate or dispute her history. In this case, the step-mother admitted abusing the child with a curling iron after a particularly loud crying spell. He reports being struck with a baton on the forearm, which the police deny.
Physical exam shows significant tenderness over the mid-forearm.
An X-ray is pictured at left. Midshaft of one of the long bones of the forearm. It occurs when the forearm is used to defend against a blow, often by an object. This supports the patient's claim that he was struck by a police baton.