The presentations of child abuse are protean and require a multidiscip
linary approach to evaluation. The final determination of abuse is a m
edicolegal decision. The role of the history and physical examination
is to provide a broad assessment of the child's environment in additio
n to documenting any findings. This is critical in the preverbal age g
roup where a detailed description of the alleged event given by variou
s caretakers may provide the only clue to abuse. The physician must re
alize that he/she is in the position to initiate removal of a child fr
om the home and take this responsibility very seriously. We present a
working guide to the allegedly abused child and highlight the need for
the clinician to appropriately refer for expert consultation when the
re are concerning findings.