Few physicians are comfortable testifying in courts of law. Fewer still are comfortable when the subject at hand involves sexual abuse and when there is often a paucity of physical or laboratory findings. Yet, with increasing public awareness, the number of cases of child sexual abuse involving the criminal justice system is dramatically increasing, with a concomitant need for expert witness testimony.

When sexual abuse is alledged, a physician may be asked to assess a child's genitalia and anus for signs of past sexual activity. In girls, this entails looking for changes in the hymen, such as tears or scarring, estimating the diameter of the introitus, and looking for dilation of the hymenal ring.1

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