Suspected sexual abuse: an unusual presentation form of congenital myotonic dystrophy

In children, anal abnormalities due to various causes may be confused with sexual abuse. We present the case of a child in whom the suspicion of abuse due to anal dilatation led to the previously unknown diagnosis of myotonic dystrophy. Myopathic involvement of the perianal musculature is a known fe ature of congenital myotonic dystrophy that usually appears in late childho od or adolescence. Conclusion We stress the importance of considering an underlying myopathic condition in the differential diagnosis of anal laxity. Further studies, su ch as anal ultrasonography, may help when the diagnosis of abuse is not cle ar.