Which feature may indicate long-term abuse in a case of non-accidental injury?

Bruising of varying degrees with color variations can indicate long-term abuse in cases of non-accidental injury. This pattern often suggests that the child has experienced multiple episodes of trauma over time, as different colors of bruises indicate injuries of varying ages. Each bruise has a specific coloring that correlates with the stages of healing, ranging from red to purple and eventually to yellow or brown as it resolves. When a child presents with bruises in various stages of healing, it raises the suspicion of repeated abuse rather than a single incident, which is typically seen with isolated injuries.

In contrast, a single bruise may result from an accidental fall or injury that can occur in active children. Recent fractures can also be associated with both accidental and non-accidental incidents, but they do not provide clear evidence of repeated trauma. Similarly, the absence of visible injuries does not offer enough evidence to suggest abuse, as some cases may have taken place without resulting in external signs. Overall, the presence of bruises with varying degrees of healing is a crucial indicator that warrants further investigation into the possibility of ongoing abuse.