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Child Abuse Case 9

A 9-year-old girl is brought for examination due to a concern by her primary care provider regarding her examination findings. The girl lives with her mother and mother’s boyfriend and two younger half-siblings. She does well in school and has no genital complaints or behavioral problems.

Case 9

Source: A. S. Botash, MD, used with permission

Which of the following is a true statement regarding the examination of this crescent-shaped hymen?

  1. The hymen edge is less than 1 mm in size at the posterior margin and the finding is suspicious for sexual abuse.
  2. The hymen edge may be rolled under and should be further evaluated with another examination technique.
  3. The examination reveals a healed transection and is clear evidence of past penetrating trauma.
  4. The width of the hymenal opening is larger than normal and is suspicious for sexual abuse.

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