RT Book, Section A1 Lindberg, Daniel M. A1 Chiesa, Antonia A1 Miller, Angie L. A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181050715 T1 Child Sexual Abuse Exam and Genital Findings (Sexual Abuse) T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181050715 RD 2024/03/29 AB The diagnosis and management of child sexual abuse differs from adult sexual assault. The majority of prepubertal victims of sexual abuse will have a normal genital exam without evidence of acute or healed trauma. Young children may present due to nonspecific findings such as behavior changes or genital rash. The history and context of concerns are often most important to make the diagnosis. Knowledge of child development and behavior informs the management and diagnosis. An emergency department (ED) physician may ask questions as necessary for the medical evaluation of the patient. As a rule, the history is obtained from the caregiver out of the presence of the child. Care should be taken to avoid leading questions, and both the question and the child’s answer should be recorded verbatim when possible. Forensic interviews should be performed by professionals trained in interviewing children for possible sexual abuse.