Is it sexual abuse? Confusion caused by a congenital anomaly of the genitalia.

Because of the increasing number of reports of sexual abuse of children, pediatricians should become more familiar with the examination of the genitalia of prepubertal children and learn to recognize physical indicators of abuse. Although some physicians may not recognize abnormal findings on examination, in other cases, unusual physical findings may be reported erroneously as possible abuse. The authors report a case of an unusual genital finding in a child which was suspected initially as being caused by sexual abuse but was subsequently determined to be a congenital anomaly. An external examination using a colposcope was useful in delineating the normal appearance of the tissues in question.