Injuries in prepubertal and pubertal girls.

In this chapter, examination techniques are first recommended, and then terminology for genital injuries that may occur after child sexual abuse or rape (e.g. lacerations, notch, transaction) are described. Current evidence for these injuries is provided. Areas of controversy (e.g. hymenal diameter, hymenal width) are described and completed with cautionary notes on inflammation, bruising, abrasions, bumps and mounds, tags, labial fusion, lichen sclerosis). The chapter concludes with a debate on normal findings that are reported to occur in up to 99% of children referred for examination.