Child abuse and neglect occur in all cultures and nations throughout the world and are major threats to the health and well-being of children. Prevention of child abuse has both immediate and long-range effects. A key component of prevention is identification and reporting by health care providers. Detection of child abuse requires a high index of clinical suspicion, as caregivers often attempt to conceal or explain away concerns. Careful investigation and accurate documentation of physical signs and examination findings are imperative. The two most common presentations of physical abuse are skin lesions and fractures, respectively. Chiropractors are mandated reporters of suspected child abuse and neglect and are obligated in all jurisdictions to comply with the law. As a health care profession in which direct personal contact, visual observation, and radiographic evaluation often occur during the examination and/or treatment of the musculoskeletal system, chiropractors are well situated to recognize the signs of intentional injuries in children.
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