REGARDLESS OF PERSONAL RELUCTANCE TO BECOME INVOLVED IN A CHILD ABUSE CASE, THE DOCTOR SHOULD REMEMBER THAT THERE IS A MORAL OBLIGATION TO THE CHILD. COMPLETE INVESTIGATION, INCLUDING A FULL RADIOGRAPHIC STUDY, IS SUGGESTED WHEN EXAMINING A CHILD WHO EXHIBITS POSSIBLE TRAUMA OR NEGLECT OR IF THERE IS A MARKED DISCREPANCY BETWEEN THE CLINICAL FINDINGS AND THE PAST HISTORY AS SUPPLIED BY THE PARENTS. THE BATTERED BABY SYNDROME IS USED TO DEFINE A CLINICAL CONDITION IN YOUNG CHILDREN, USUALLY UNDER THE AGE OF 3, WHO HAVE RECEIVED NONACCIDENTAL VIOLENCE, INJURY OR NEGLECT. CHARACTERISTIC INJURIES ARE SUBDURAL HEMORRHAGE, FRACTURED SKULLS, AND INJURIES TO THE ABDOMEN. PERMANENT IMPAIRMENT OF VISION IS A WELL-RECOGNIZED COMPLICATION OF BATTERED CHILDREN. DOCTORS ARE OFTEN HESITANT TO DIAGNOSE CHILD ABUSE DUE TO A RELUCTANCE TO BELIEVE THAT A PARENT COULD BE GUILTY OF SUCH AN ATTACK, TO LACK OF CONFIDENCE IN THEIR OWN JUDGMENT, OR TO A FEAR THAT THE PATIENT-DOCTOR RELATIONSHIP MAY BE JEOPARDIZED. CHILD ABUSE IS CLASSIFIED INTO FOUR MAJOR TYPES: (1) TRUE INFANTICIDE; (2) CHILD NEGLECT; (3) DELIBERATE CRUELTY OVER A PERIOD OF TIME; AND (4) THE BATTERED CHILD. THE VICTIM OF THE FOURTH TYPE SHOWS SURFACE MARKS SUCH AS ABRASIONS, BRUISES, AND BURNS, AS WELL AS VARIOUS SKELETAL AND VISCERAL INJURIES. THE VICTIM IS GENERALLY AN UNWANTED CHILD, AND ONE CHILD OF A FAMILY IS OFTEN TARGETED FOR ABUSE. THERE IS GENERALLY A HISTORY OF FAMILY DISCORD, LONG-STANDING EMOTIONAL PROBLEMS, OR FINANCIAL STRESS. MOST OF THE BATTERING OCCURS IN LOW-INCOME FAMILIES, AND IN MOST CASES THERE IS DEFECT IN THE CHARACTER STRUCTURE OF THE ABUSING PARENT. BIBLIOGRAPHICAL REFERENCES ARE PROVIDED. (DAG)