Impact of telemedicine on the quality of forensic sexual abuse examinations in rural communities.

To assess the quality and diagnostic accuracy of pediatric sexual abuse forensic examinations conducted at rural hospitals with access to telemedicine compared with examinations conducted at similar hospitals without telemedicine support. Medical records of children less than 18 years of age referred for sexual abuse forensic examinations were reviewed at five rural hospitals with access to telemedicine consultations and three comparison hospitals with existing sexual abuse programs without telemedicine. Forensic examination quality and accuracy were independently evaluated by expert review of state mandated forensic reporting forms, photo/video documentation, and medical records using two structured implicit review instruments.

Using telemedicine to improve the care delivered to sexually abused children in rural, underserved hospitals.

Objective: We used live telemedicine consultations to assist remote providers in the examination of sexually assaulted children presenting to rural, underserved hospitals. We hypothesized that telemedicine would increase the ability of the rural provider to perform a complete and accurate sexual assault examination.

Patients And Methods: Child abuse experts from a university children's hospital provided 24/7 live telemedicine consultations to clinicians at 2 rural, underserved hospitals.

Comparison of examination methods used in the evaluation of prepubertal and pubertal female genitalia: a descriptive study.

Objective: To compare the effectiveness of three different examination methods in their ability to help the examiner detect both acute and non-acute genital injuries in prepubertal and pubertal girls suspected of having been sexually abused.

Methods: Forty-six prepubertal and 74 pubertal girls, whose ages ranged from 4 months to 18 years, were evaluated to determine the relative effectiveness of three different examination methods.

Results: All the girls had sustained a recent genital injury from various causes.

Healing of nonhymenal genital injuries in prepubertal and adolescent girls: a descriptive study.

Objective: The objective of this study was to identify the healing process and outcome of nonhymenal injuries in prepubertal and pubertal girls.

Methods: This multicenter, retrospective project used photographs to document the healing process and outcome of nonhymenal genital injuries in 239 prepubertal and pubertal girls whose ages ranged from 4 months to 18 years.

Results: The genital injuries sustained by the 113 prepubertal girls consisted of 21 accidental or noninflicted injuries, 73 injuries secondary to abuse, and 19 injuries of unknown cause.

Healing of hymenal injuries in prepubertal and adolescent girls: a descriptive study.

Objective: The objective of this study was to identify the healing process and outcome of hymenal injuries in prepubertal and adolescent girls.

Methods: This multicenter, retrospective project used photographs to document the healing process and outcome of hymenal trauma that was sustained by 239 prepubertal and pubertal girls whose ages ranged from 4 months to 18 years.

Results: The injuries that were sustained by the 113 prepubertal girls consisted of 21 accidental or noninflicted injuries, 73 secondary to abuse, and 19 "unknown cause" injuries.

Anogenital injuries in child pedestrians run over by low-speed motor vehicles: four cases with findings that mimic child sexual abuse.

Objective: Differentiating between child sexual abuse and nonintentional causes of anogenital injury can be challenging, and a misdiagnosis can have a profound impact on the child and family. This case series documents an important nonintentional mechanism of anogenital injury that mimics the physical findings of child sexual abuse.

Methods: Four children were examined after being run over by a slow-moving motor vehicle.