September 1, 2012
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Child abuse is not uncommon and frequently presents to the emergency department (ED). Sometimes the presentation is subtle and masked by vague histories and nonspecific physical findings. Considering sexual abuse in the differential diagnosis is important for the child and his or her safety. Understanding techniques for obtaining a directed history and recognizing the physical findings and abnormalities that are associated with abuse will enable the physician to complete a thorough evaluation and to document with confidence. High-risk populations, such as children with special needs, present unique challenges to the clinician. This article reviews the history, physical examination, diagnostic evaluation, and reporting expectations for children with suspected sexual abuse.