EVALUATION FOR POSSIBLE PHYSICAL OR SEXUAL ABUSE

The presentations of child abuse are protean and require a multidiscip linary approach to evaluation. The final determination of abuse is a m edicolegal decision. The role of the history and physical examination is to provide a broad assessment of the child's environment in additio n to documenting any findings. This is critical in the preverbal age g roup where a detailed description of the alleged event given by variou s caretakers may provide the only clue to abuse. The physician must re alize that he/she is in the position to initiate removal of a child fr om the home and take this responsibility very seriously. We present a working guide to the allegedly abused child and highlight the need for the clinician to appropriately refer for expert consultation when the re are concerning findings.