Child Abuse and Birth Injuries

Explanation

In any infant with a suspicious fracture, a skeletal survey is the standard of care. This is a systematic series of radiographs designed to identify other occult fractures that may be in different stages of healing, which is a hallmark of non-accidental trauma. While a head CT (A) is crucial in a lethargic or symptomatic infant, the skeletal survey is the broader, systematic screen. A detailed history (C) is important but should not delay objective diagnostic imaging. A coagulation panel (D) may be part of a secondary workup but is not the first priority when physical findings strongly suggest trauma.