The Rational Clinical Examination
David L. Simel, Drummond Rennie
Sexual Abuse, Child
Molly Curtin Berkoff, Adam J. Zolotor, Kathi L. Makoroff, Jonathan D. Thackeray, Robert A. Shapiro, Desmond K. Runyan
children's health, examination of vagina, female genitalia, gynecological examination, hymen, pediatrics, sexual abuse, sexual abuse of child
"A 6-year-old girl is brought to the emergency
department by her mother. The mother states her child said a male
babysitter "touched her" in the genital area.
The mother reported the case to the police and was advised to bring
the child to the emergency department for a medical examination.
No behavioral problems were reported. The emergency department nurse
asked the child why she thought her mother brought her to the hospital,
and the child reported because of "what happened" with
the babysitter. No further details were obtained. On physical examination
she is sexual maturity rating 1. You note mild erythema of the inner
aspect of the labia minora. The hymen is well visualized and appears
normal. There is no bleeding, discharge, or lesions seen around
the genitalia or anus. There are no other concerning examination
findings. Is the lack of findings reassuring?..."
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