Which characteristic of a bruise might suggest that it is due to abuse rather than an accident?

Color variations in a bruise can indicate abuse because bruises from different mechanisms of injury often display a spectrum of colors as they heal. In cases of trauma resulting from accidental incidents, it is more typical for bruises to occur in similar color stages, reflecting a singular impact or injury event.

In contrast, if a child has multiple bruises at varying stages of healing—each exhibiting different colors—this might suggest that the child has experienced multiple instances of trauma over time, which can be a red flag for non-accidental injury or abuse. Specifically, bruises can progress in color from red to purple to green and yellow as they heal, and the presence of various colors may indicate that different injuries occurred at different times.

Localized bruising, a single bruise, or healed bruises alone might not provide the same level of concern for potential abuse as the variations in color do. While each of those characteristics may warrant further examination, it is the color variation that particularly highlights the possibility of repeated injuries that could suggest a pattern of abuse.