Lacerations and abrasions. Children often have scraped knees, shins, palms, or elbows-predictable injuries. When children have lacerations and abrasions in soft tissue areas, such as on the abdomen, back, backs of arms and legs or external genitalia. It is a strong indicator of physical abuse. Human bite marks, especially when they are recurrent and appear to be adult sized, are also strongly indicative of abuse.
Unexplained fractures are cause for concern.
A child with multiple fractures is almost certain to be a victim of abuse. Other signs include swollen or tender limbs and spiral fractures caused by jerking of the arms. Children who have been physically abused also are likely to show signs of childhood stress. Childhood stress can result from any upsetting situation in the child's environment such as a family disruption, death of a pet, or even a move to a new neighborhood. It can also be a result of child abuse.