Physical Examination

The physical examination consists of preparing the child/adolescent for the examination, a general physical examination, a genital examination, and when appropriate, the collection of physical evidence. Laboratory and radiographic evaluations may also be necessary. The separate parts of the evaluation are conducted simultaneously; however, they are presented separately for clarity. To better prepare for the exam, it is important for the medical provider to review as much information as possible prior to the physical examination. For example, in addition to a good history from the patient and caregivers, data from child protectives services, police or others should be reviewed. In many cases, this additional information will enable better trauma informed preparation of the child, setting expectations for the examination, and understanding and preparation for needed testing and treatment.

The goals of the examination are:

  • Minimize further emotional trauma to the child/adolescent by using appropriate preparation and examination techniques
  • Identify injuries that must be treated, including signs of abuse or neglect, such as failure to thrive, genital findings, bruises, burns, lacerations, and fractures
  • Identify medical conditions that should be treated, such as sexually transmitted infections (STIs) or pregnancy
  • Collect medical-legal evidence, when appropriate
  • Reassure the child/adolescent and parent/caregiver that the child/adolescent will recover, that any acute injuries present will be treated, or that old injuries have healed

The goal of the examination is not to “rule-out” abuse. That is, a normal examination does not mean child abuse did not occur.

Key Concepts

Table of Contents

Physical Examination