Information has been excerpted from VisualDx clinical decision support system as a public health service. Additional information, including symptoms, diagnostic pearls, differential diagnosis, best tests, and management pearls, is available in VisualDx.
Hematomas present with edema and poorly demarcated, nonblanching, violaceous discoloration of the skin.
For girls, findings highly specific for abuse include acute laceration of the hymen (partial or complete) and hymenal ecchymosis.
For boys, bruising can occur on any part of the penis, scrotum, perineum, or perianal area, and the color may vary depending on the stage of resolution it is in.
In comparison, accidental injuries, such as straddle injuries, are typically unilateral and superficial and involve the anterior portion of the genitalia, particularly the labia minora or urethra and not the hymen. Picket fence injuries may produce hymenal trauma.
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