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Journal Article


Pugno PA. Arch. Family Med. 1999; 8(5): 403-406.


M.H.S. Family Practice Residency Program, Methodist Hospital of Sacramento, USA.


(Copyright © 1999, American Medical Association)






OBJECTIVE: To evaluate the usefulness of the horizontal transhymenal diameter as a screening parameter to differentiate between prepubertal girls with and without other definitive signs of sexual abuse. DESIGN: Case comparison study using transhymenal measurements as a diagnostic screening test referenced against prior publications of criterion standards. SETTING: A primary care (family practice) clinic in association with an academic program in northern California. PATIENTS: A consecutive, referred sample of 1058 prepubertal girls aged 6 months to 10 years who were examined as allegedly having been sexually molested between 1987 and 1994. RESULTS: Girls with no definitive signs of genital trauma exhibited a mean transhymenal diameter of 2.3 mm and in general showed an increase of approximately 1 mm per year of age. Girls with definitive signs of genital trauma exhibited a mean transhymenal diameter of 9.0 mm and no significant variance with age. Correcting for age differences, the transhymenal diameter was highly significant as a differentiating factor (F = 1079, P < .001). When compared against the criterion standard, the transhymenal measurement is 99% specific and 79% sensitive as a screening tool. CONCLUSION: Although not independently diagnostic of sexual molestation, the transhymenal diameter, when compared against the criterion standard for age, is a useful screening parameter for primary care physicians evaluating children of potential sexual abuse.

Language: en


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