Board Certified Expert Witness Anal Anatomy Child Sexual Abuse:

The evaluation of potential anal injuries requires careful analysis of the examination, photos, protocol and correlation with relevant research.  An assessment of a case with anal findings potentially concerning for sexual abuse by a board certified child abuse pediatrician warrants such an opportunity.  Whereas forensic (SANE) nurses may conduct an exam, it is paramount for a case to have review by a board certified child abuse MD pediatrician to assure accuracy, noting the scope of practice for an RN limits the ability to render a diagnosis.

Case Examples Anal Findings in Child Sexual Abuse:

4 year old child with abdominal trauma and SANE nurse concerned for anal injuries that may have been sexual abuse.  Differential includes secondary injury from the abdominal trauma.

7 year old child with diarrhea and other medical problems, pediatrician concerned for anal findings and sexual abuse.  Differential includes skin breakdown and fissures from diarrhea.

15 year old child with exam findings within normal limits called “variants” such as anal skin tags and subjective tone assessment. Doctor called in case for sexual abuse.  Provider did not utilize evidence based practice in assessment and the exam was normal.