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Child sexual abuse Differential Diagnosis
Beside the normal findings, normal variants and unspecific findings, there are a number of important differential diagnoses to consider when evaluating children with abnormal anogenital findings…

Normal Findings – Anatomy and Terminology
For professionals involved in the evaluation of children for possible sexual abuse, it is crucial to develop a thorough understanding of the appearance of the anogenital anatomy both…

Gynecological Examination of a Prepubertal Child
A full gynecological examination of the child mainly includes inspection of external genitalia and in some cases rectal examination. Vaginoscopic examination and samples are…

If a cyst is totally anechogenic, all teams agree that the patient should be monitored for a period ranging from 4 weeks to 6 months. Control ultrasound studies done 2…

Ovarian Neoplasms

Benign Teratomas
Dermoid cysts are the most frequent neoplasms in childhood, with the mean age of diagnosis being 10 years. These are benign germinal…

Other Endocrine Affection
Acquired Infantile Hypothyroidism. During childhood, the onset of signs of hypothyroidism may be very insidious and they may follow their course for…

Hormonal Activation or Interaction
Central Pituitary Involvement: Transient or Persistent Activation?
Small asymptomatic cysts are a common finding in young girls. Large cysts, although less common,…

Diagnostic Arguments of Ovarian Cysts in Prepubertal Girls
Pelvic Ultrasonography
Pelvic ultrasonography is central to the management of ovarian cysts.

Classically, it is carried out by…

In spite of an abundance of data on medical findings in CSA victims and their differentiation from normal, normal variants and other differential diagnoses, the medical proof of abuse remains the exception…

Sexually transmitted diseases (STD) are discussed in a different sections of this site. We only refer to a few important characteristics with regard to CSA.

STD may be the only medical indicator of sexual…

Extragenital Signs of Sexual Abuse
Those signs are infrequent and rather seen in the context of rape: hematomas and bite marks in the so-called erogenous zones, especially the inner thighs, breasts,…

Forensic Evidence Collection and Interpretation
Forensic evidence is infrequently found in CSA cases due to reasons discussed earlier (delayed disclosure, etc.). However, in selected cases the medical…

Physical Examination - Child sexual abuse
The preparation and conduct of the physical examination of sexually abused children requires ‘time, patience and a gentle manner…’ [Horowitz, 1987].

Appropriate timing of…