March 2009. Volume 5. Number 1

Clinical examination does not provide conclusive results confirming the diagnosis in prepubertal girls with suspected sexual abuse

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Berkoff M C, Zolotot A,J, Makoroff K.L, Thackeray J D, Shapiro R.A, Runyan D K. Has this prepubertal girl been sexually abused? JAMA. 2008;300:2779-92
Reviewers: Aparicio Rodrigo M1, Juanes de Toledo B2.
1Centro de Salud Entreví­as. Área 1. Madrid. España.
2 Equipo de Atención Primaria El Espinillo. Área 11. Madrid. España.
Correspondence: María Aparicio Rodrigo. Email: maparicio@salud.madrid.org
Reception date: 01/02/2009
Acceptance date: 04/02/2009
Publication date: 06/02/2009

Abstract

Authors' conclusions: the physical exam cannot independently confirm or exclude nonacute sexual abuse in prepubertal girls. Vaginal discharge and/or posterior hymenal transections rise the suspicion of sexual abuse. The absence of hymenal transection is associated with low probability of sexual abuse.

Reviewers' comantary: there is no evidence of the diagnostic usefulness of the physical findings after the first 72 hours of a sexual assault. Vaginal discharge and/or hymenal transection are present in less than half of the cases, but their existence produce a high level of suspicion. Moreover, genital lesions are only one of the types of sexual abuse in childhood, and in 95% of prepurbertal girls that have suffered sexual abuse there are no findings in the physical exam.

How to cite this article

Aparicio Rodrigo M, Juanes de Toledo B. Titulo. En niñas prepuberales con sospecha de abuso sexual, el examen clínico no aporta resultados concluyentes. Evid Pediatr. 2009;1:12.

AVC | Critically appraised articles

Berkoff M C, Zolotot A,J, Makoroff K.L, Thackeray J D, Shapiro R.A, Runyan D K. Has this prepubertal girl been sexually abused? JAMA. 2008;300:2779-92
Reviewers: Aparicio Rodrigo M1, Juanes de Toledo B2.
1Centro de Salud Entreví­as. Área 1. Madrid. España.
2 Equipo de Atención Primaria El Espinillo. Área 11. Madrid. España.
Correspondence: María Aparicio Rodrigo. Email: maparicio@salud.madrid.org
Reception date: 01/02/2009
Acceptance date: 04/02/2009
Publication date: 06/02/2009

How to cite this article

Aparicio Rodrigo M, Juanes de Toledo B. Titulo. En niñas prepuberales con sospecha de abuso sexual, el examen clínico no aporta resultados concluyentes. Evid Pediatr. 2009;1:12.

References

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  2. Christian CW, Levalle JM, De Long AR, Loiselle J, brenner L, Joffe M. Foresic evidence findings in prepuberal victims of sexual assault. Pediatrics. 2000;106:100-4.
  3. Adams JA, Harper K, Hnudson S, Revilla J. Examination findins in legally confirmed child sexual abuse: it´s normal to be normal. Pediatrics. 1994;94:310-7.
  4. Adams JA. Medical evaluation of suspected child sexual abuse. J Pediatr Adolesc Gynecol. 2004:17:191-7.
06/02/2009

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