Guidelines for Documentation and Evaluation of Cord‑Whip Injuries in Suspected Child Physical Abuse

1. Comprehensive Injury Documentation

Detailed photographic documentation together with written descriptions of injury location, pattern, size, and color is essential because cord‑whip injuries are superficial soft‑tissue sentinel markers that support forensic and legal proceedings. 1
Record the precise anatomical location of each lesion (e.g., posterior thorax, lateral thigh, buttocks) and indicate whether the site is typical for abuse versus accidental injury. 1
Describe the injury pattern; cord‑whip marks are characteristically linear, looped, or parallel, and the pattern helps infer the type of implement used. 2
Measure each lesion’s length and width in centimeters and note these dimensions in the chart. 1
Document the exact color of each lesion (e.g., red, purple, brown, yellow‑green); color assists with injury dating, although dating by color alone is unreliable. 4
Count the total number of injuries and indicate whether they appear in clusters or across multiple regions, as multiple injuries strongly suggest abuse. 5
Include the child’s developmental history (motor capabilities) to assess whether the reported mechanism of injury is plausible for the child’s age and abilities. 5

Perform a complete skeletal survey in children ≤ 24 months because occult fractures are present in 11–20 % of abuse cases even when not clinically suspected. 5
Obtain a non‑contrast head CT in neurologically asymptomatic young infants, since occult intracranial injury occurs in approximately 29 % of such cases. 5

Report to child protective services when the injury pattern is inconsistent with the provided history or suggests inflicted trauma (e.g., linear whip marks from cords). 1
Report when multiple injuries of differing ages are identified, indicating ongoing or repeated abuse. 5
Report when the injury is inconsistent with the child’s developmental capabilities. 5