Citation

Smith TD, Raman SR, Madigan S, Waldman J, Shouldice M. J. Pediatr. Adolesc. Gynecol. 2018; 31(2): 79-83.

Copyright

(Copyright © 2018, North American Society for Pediatric and Adolescent Gynecology, Publisher Elsevier Publishing)

DOI

10.1016/j.jpag.2017.10.006

PMID

29111300

Abstract

OBJECTIVES: Accurate interpretation of ano-genital examination findings in the context of suspected child and adolescent sexual abuse/assault is essential, as misinterpretation has significant child protection and criminal justice implications. A consensus approach to the interpretation of ano-genital examination findings is widely utilized to support accurate diagnosis; however, a large-scale study using this standardized approach is lacking. The objectives of this study are to: 1) determine the proportion of ano-genital examinations for sexual abuse concerns with findings diagnostic of trauma and/or sexual contact; 2) determine whether frequency of diagnostic findings varies by age, gender, timing of examination; and 3) characterize diagnostic findings.

METHODS: Retrospective records of children aged 0-18 years evaluated for sexual abuse/assault were reviewed. Case details of 3569 patients were extracted and ano-genital examination findings were re-interpreted using a published consensus approach(1).

RESULTS: Ano-genital examination findings diagnostic of trauma and/or sexual contact were present in 173 of 3569 patients (4.9%). The prevalence of diagnostic findings was significantly higher in adolescents than in children under 12 years of age (13.9% vs. 2.2%), in females versus males (5.7% vs. 1.5%) and in examinations within 72 hours for children under 12 (14.2% vs 4.5%). Acute injuries were the most common type of diagnostic finding.

CONCLUSIONS: Diagnostic findings are present in a small proportion of children and adolescents examined for suspected sexual abuse/assault. It is essential that practitioners interpreting examination findings be adequately trained and familiar with the current consensus approach and aware of case characteristics associated with higher likelihood of findings.

Copyright © 2017. Published by Elsevier Inc.

Language: en

Keywords

child sexual abuse; examination findings