A wet mount slide, routine vaginal culture, and cultures for gonorrhea and , either from a urine sample or from a vaginal swab, but the current criterion standard for diagnosis in cases of suspected sexual abuse is still culture.
NAATs are very sensitive and generally yield a low false-positive rate; however, if the urine NAAT findings are positive for either gonorrhea or cultures are not available.
Genital complaints in prepubertal girls are not rare, and all clinicians who examine children need to be familiar with the conditions that can cause genital redness, itching, discharge, bleeding, and pain.
Understanding the wide variations in the appearance of the hymen and other genital tissues in prepubertal girls is also necessary.In 2013, the American Academy of Pediatrics published an updated clinical report on the subject of suspected child sexual abuse with guidance for the clinician in deciding when a report to protective services is necessary.When a child makes a statement or a disclosure of abuse and describes sexual touching, all 50 US states mandate that the clinician report suspected child sexual abuse to the local child protective services agency, law enforcement, or both.However, if concerns about possible abuse are based only on a physical sign or symptom, the child must be examined by a healthcare provider who is familiar with the nonabusive causes of the symptoms or signs.
See the recommendations from the Centers for Disease Control and Prevention.
One position for the patient while the physician is conducting the examination is lying on her back on the examination table in the supine frog-leg position with her knees bent and the soles of her feet touching.