nl_e17

APPENDIX A: ABUSE DOCUMENTATION USING PHOTOGRAPHY AND COLPOSCOPY
Documentation of visual findings is an important component of child abuse evaluation. Apart from
careful examination and written documentation, photographs are useful adjuncts to preserve visual
findings. These photographs assist physicians in recalling or re-confirming findings, or in
discovering previously undetected results; should a second opinion be required, high quality
photographs can be reviewed in lieu of re-examination, thus sparing the child unnecessary trauma.
Further, physicians may use photographs to illustrate and further clarify their testimony when
serving as expert witnesses in court. Finally, photographs facilitate technical peer review: by
obtaining the opinions of their peers on difficult-to-evaluate cases, child protection specialists
improve their skills, benefiting from the experience and expertise of others.
A colposcope is a binocular instrument used to visualize ano-genital structures during sexual abuse
evaluations. Each colposcope offers a light source and varying magnification capability, and may
also attach to a camera in order to photograph genital injuries. Although colposcopic photography is
used primarily to document abnormal findings, it may also be prudent to photograph cases with
normal findings, as these photographs may be of comparative value if the patient is later reexamined.
Colposcope