Interpretation of medical findings in suspected child sexual abuse: an update for 2018.
Open accessAbstract
Most sexually abused children will not have signs of genital or anal injury, especially when examined nonacutely. A recent study reported that only 2.2% (26 of 1160) of sexually abused girls examined nonacutely had diagnostic physical findings, whereas among those examined acutely, the prevalence of injuries was 21.4% (73 of 340). It is important for health care professionals who examine children who might have been sexually abused to be able to recognize and interpret any physical signs or laboratory results that might be found. In this review we summarize new data and recommendations concerning documentation of medical examinations, testing for sexually transmitted infections, interpretation of lesions caused by human papillomavirus and herpes simplex virus in children, and interpretation of physical examination findings. Updates to a table listing an approach to the interpretation of medical findings is presented, and reasons for changes are discussed.
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Genital warts have been diagnosed among children who have been sexually abused but also among children who have no other evidence of sexual abuse; lesions appearing for the first time in a child aged >5 years are more likely to have been caused by sexual transmission.
“Genital warts have been diagnosed among children who have been sexually abused (1426) but also among children who have no other evidence of sexual abuse (1446,1447); lesions appearing for the first time in a child aged >5 years are more likely to have been caused by sexual transmission (1448).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1448]
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Experimental — accuracy not yet measuredIf a health care provider has reasonable cause to suspect child abuse, a report must be made.
“Although the exact requirements differ by state or territory, if a health care provider has reasonable cause to suspect child abuse, a report must be made (1448).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1448]
The Introduction and Documentation sections discuss medical assessment and recording examination findings, not a duty to report suspected abuse. Searches for reasonable cause, mandatory reporting, and state or territory reporting requirements found no passage addressing the claimed legal obligation. Page numbers were not available in our copy. (LLM, conf=0.72)
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References 24 · Cited by 163
Research works printed but not linked: 1
- Hobbs MM, Sena AC: Modern diagnosis of Trichomonas vaginalis infection. Sex Transm Infect 2013; 89:434
- Authors
- Adams, J. A., Farst, K. J., & Kellogg, N. D.
- Affiliations
- University of California San Diego (US)
- University of Arkansas for Medical Sciences (US)
- The University of Texas at San Antonio Health Science Center (US)
- Corresponding author
- Adams, Joyce A.
- ORCID
- Kellogg, Nancy D.
- Venue
- Journal of Pediatric and Adolescent Gynecology
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 31
- Issue
- 3
- Pages
- 225-231
- ISSN
- 0932-8610 (ISSN-L)
- 1083-3188
- OpenAlex
- W2779968122
- Cited by
- 163
- References
- 24
- Citations by year
- 2026: 16 · 2025: 10 · 2024: 14 · 2023: 22 · 2022: 26 · 2021: 26 · 2020: 27 · 2019: 14 · 2018: 8
- FWCI
- 14.67
- Type
- journal article
- Language
- en
- Update notices
- erratum (2018-12-01)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Pediatric and Adolescent Gynecology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child Abuse and Related Trauma
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
- Keywords
- child sexual abuse, genital trauma, sexually transmitted infections, clinical documentation
- MeSH terms
- Adolescent, Child, Child Abuse, Sexual, Child, Preschool, Documentation, Female, Genitalia, Humans, Male, Physical Examination, Sexually Transmitted Diseases, Practice Guidelines as Topic
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