Factors that should be noted in the medical examination of a child's injury include the child's and the parent's explanation of how the injury occurred, delay in seeking medical care, typical sites of inflicted bruises, human hand marks and bite marks, strap marks, and bizarre marks. This paper assists medical professionals in distinguishing inflicted from accidental bruises by describing some signs of accidental bruises, including accidental unusual bruises and pseudobruises. Separate sections of the paper cover the nature of inflicted burns, inflicted bone injuries, inflicted eye injuries, inflicted head injuries (subdural hematomas, accidental head injuries from falls), and inflicted abdominal injuries. Steps in the medical management of physical abuse are to elicit a detailed history of the abuse, perform a thorough physical examination, order bone survey x-rays on selected cases, order a bleeding disorder screen on selected cases, obtain color photographs on selected cases, screen the child for behavior and developmental problems, inform parents of the diagnosis and the need to report it, report all cases to child protective services by phone and in writing, hospitalize selected cases, and examine all siblings within 12 hours. 22 references.