Table 2.

Injury pattern of non-accidental burns

• Obvious pattern from cigarettes, lighters, irons

• Burns to soles, palms, genitalia, buttocks, perineum

• Symmetrical burns of uniform depth

• No splash marks in a scald injury. A child falling into a bath will splash; one that is placed into it may not

• Restraint injuries on upper limbs

• Is there sparing of flexion creases—that is, was child in fetal position (position of protection) when burnt? Does this correlate to a “tide line” of scald—that is, if child is put into a fetal position, do the burns line up?

• “Doughnut sign,” an area of spared skin surrounded by scald. If a child is forcibly held down in a bath of hot water, the part in contact with the bottom of the bath will not burn, but the tissue around will

• Other signs of physical abuse—bruises of varied age, poorly kempt, lack of compliance with health care (such as no immunisations)