Official websites use. Share sensitive information only on official, secure websites. When child sexual abuse is suspected, it is important for medical professionals to understand normal as well as abnormal features of the external genital and anal tissues in children.
Physicians and other healthcare professionals who rarely perform a detailed examination of these areas may mistakenly interpret normal findings, or findings caused by conditions unrelated to abuse, as signs of injury due to sexual abuse. For this reason, it is important for all medical professionals to have a basic understanding of the appearance of the genital and anal tissues in children.
Examples of normal and abnormal genital and anal findings are provided via annotated images. This review presents a research-based summary of how medical findings in children should be interpreted with respect to possible sexual abuse.
Resources for obtaining expert review of medical findings are described. Sexual abuse of children is not a new problem, having been described in ancient texts 1 ā 3. The acknowledgement of the problem and an attempt to understand medical findings in sexually abused children was reported in medical literature in the s 4 , 5. A detailed discussion of the history of the medical response to child sexual abuse can be found in the chapter by Rich Kaplan MS MD in a medical textbook first published in 6.
By , physicians started to become aware of the need to recognize both the physical and sexual abuse of children, thanks to the efforts of Henry Kempe MD 7 , 8. Pediatricians who were beginning to examine children with suspected sexual abuse began using a colposcope with a camera attached to obtain magnified images of the genital and anal structures.
