Common conditions that mimic findings of sexual abuse

Sexual abuse is a problem of epidemic proportions in our society. Given the prevalence of sexual abuse, it is vital for medical providers, including pediatric nurse practitioners, to recognize sexual abuse in their patients and respond appropriately. Failing to recognize sexual abuse can leave children at risk for continued abuse and potentially lead to the sexual abuse of additional children. Serious ramifications also can arise when sexual abuse is diagnosed erroneously. Children can be removed from their homes and placed in foster care. An innocent person can be prosecuted. It is important for pediatric nurse practitioners to understand that the majority of children who are sexually abused will have a normal or nonspecific ano-genital examination. However, physical findings of sexual abuse are noted in approximately 4% of children who give a history of sexual abuse. Certain clinical findings can mimic sexual abuse. This article will discuss some of the more common findings mistaken for sexual abuse and assist the pediatric nurse practitioner in correctly recognizing these findings and responding appropriately.