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APPENDIX G: Findings That May Be Confused with Abuse

Examination Findings in Newborns That Are Due to Birth Trauma

  • Retinal hemorrhages may be normal up to six weeks
  • Facial or other petechiae or bruises up to one week after birth
  • Skull fractures
  • Clavicle fractures
  • Erb's palsy due to positioning of the child's arm during birth

Other Newborn Examination Findings

  • Vaginal discharge in female newborns, possibly bloody
  • Variations of normal hymen configurations
  • Congenital pigmented lesions (Mongolian spots)

Toddler and Preschooler Findings

  • Bruising due to other causes (hematologic or syndrome such as Ehler's Danlos)
  • Straddle injury of the genital area
  • Vaginal discharge due to other causes of vaginitis
  • Genital complaints due to urinary tract infection, perianal or perivaginal pinworms, Group A Strep, cellulitis, or lichen sclerosis et atrophicus
  • Urethral prolapse

Middle Childhood and Adolescent Findings

  • Bruising due to other causes (hematologic or syndrome such as Ehler's Danlos)
  • Straddle injury of the genital area
  • Vaginal discharge due to other causes of vaginitis
  • Genital complaints due to urinary tract infection, perianal or perivaginal pinworms, Group A Strep, cellulitis, or lichen sclerosis et atrophicus
  • Urethral prolapse




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Appendices  Appendix A: Post-Assault Testing and Treatment  Appendix B: A Sample Continuum of Medical History Questions and Confidence in the Responses  Appendix C: Body Diagrams  Appendix D: Burn Assessment - Rule of Nines  Appendix F: Common Types of Diaphyseal Fractures Seen in Childhood  Appendix G: Findings That May Be Confused with Abuse  Appendix H: Differential Diagnosis Table  Appendix I: List of Community Services  Appendix J: Supplemental Resources  Appendix K: Emergency Contraceptive Pills 

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