nl_e17

Injuries Indicative of Abuse
Class 2 Nonspecific
Findings that may be the
result of sexual abuse,
depending on the timing
of the examination with
respect to the abuse, but
which also may be due
to other causes.
Erythema (redness) of
the vestibule or
increased vascularity
(“dilatation of existing
blood vessels”) of
vestibule
Superficial abrasions
of the labia or posterior
fourchette
Shallow notches in
the posterior rim of
hymen extending
through 50% or less of
the width of the
hymenal rim
“Narrow” rim of
hymen measuring 1-2
mm wide
Labial adhesion
Vaginal discharge
Vesicular lesions or
ulcers in the genital area
Genital warts in a
child
Blood on underwear
“Vaginal” bleeding
(Found in both abused
and non-abused
children/adolescents)
(ii, iii, iv, v, xi)
Class 2 Nonspecific
Erythema (redness) of
the perianal tissues
Anal fissures
Anal dilation without
stool visible
Superficial abrasions
of the perianal skin
Bruises on the
buttocks
Vesicles or ulcers in
the anal area or on the
buttocks
Bleeding from the
anus (ii, iii, iv, v)
http://www.pathguy.com/adams.htm (2 of 10) [6/5/2005 8:46:54 PM]
Class 2 Nonspecific
Erythema of penis,
lower abdomen or inner
thighs
Edema of
penis/scrotum
(These may result from
self-manipulation, poor
hygiene, contact
irritation/inflammation,
or infection)
Superficial abrasions
on the penis/scrotum
Warty lesions or
vesicular lesions on the
penis/scrotum
Class 2 Nonspecific:
May be transmitted by
sexual or nonsexual
means:
Herpes type I or II in
a child who requires
caretaker assistance
with toileting or
hygiene, or who may
have self-innoculated
from an oral lesion
Bacterial vaginosis in
a child or adolescent
Any STD (including
HPV or genital wards)
in an infant who may
have acquired it
perinatally (vii)