nl_e17

Injuries Indicative of Abuse
Class 3 Concerning for
Abuse
Findings that have been
noted in children with
documented abuse, and
may be suspicious for
abuse, but for which
insufficient data exists
to indicate that abuse is
the only cause.
Acute trauma - suspect
sexual abuse:
Acute lacerations or
bruising of labia, fossa,
posterior fourchette or
perihymenal tissues
Bruises or bites to
upper or inner thighs
near genitalia
Sucker/hickey marks
on inner thighs near
genitalia
Possible healed
injuries from abuse:
Scar of the posterior
fourchette
Hymenal notch/cleft
extending through more
than 50% of the
posterior (inferior) or
lateral portion of the
hymenal rim
Class 3 Concerning for
Abuse
Acute trauma - suspect
sexual abuse:
Marked bruising and
edema of the perianal
tissues, as distinguished
from venous pooling
Possible residual from
trauma:
Perianal scar (may be
due to healed fissure
from Crohn’s Disease or
from surgery)
http://www.pathguy.com/adams.htm (3 of 10) [6/5/2005 8:46:54 PM]
Class 3 Concerning for
Abuse
Acute trauma - suspect
physical or sexual
abuse:
Banding of penis with
child’s hair or other
objects (this may be
accidental in infants,
from hair of a caretaker)
Bite or pinch marks
on penis, scrotum, or
inner thighs near
genitalia
Sucker/hickey marks
on inner thighs near
genitalia
Class 3 Concerning for
Abuse: Sexual
transmission is likely
cause of infection:
Herpes type I or II
lesions in the genital
area in a child who has
no oral lesions and
requires no assistance
with toileting or hygiene
Trichomonas
infection diagnosed by
wet mount preparation
or culture of vaginal
secretions
HPV infection in a
child in whom perinatal
transmission is
considered unlikely (vii)