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Abusive Head Trauma — RACP Paediatrics MCQ

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HardEmergency PaediatricsAbusive Head TraumaRACP Paediatrics

A 2-month-old presents with irritability, full fontanelle, retinal haemorrhages, and a subdural haematoma on CT. No history of accidental trauma. What diagnosis must be considered?

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Correct answer: D — Abusive head trauma (previously shaken baby syndrome)

The triad of subdural haematoma, retinal haemorrhages, and encephalopathy in an infant without a clear accidental mechanism is highly suggestive of abusive head trauma. A full child protection assessment including skeletal survey, ophthalmological examination, clotting studies, and metabolic investigations (to exclude rare mimics like glutaric aciduria) is required.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Abusive Head Trauma