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Doody's Review ServiceReviewer: Naomi F. Sugar, MD (Harborview Medical Center)
Description: This extensive revision of the 1992 publication on evaulatuion of the sexually abused child is 80 pages longer and includes an expanded photographic atlas and a CD-ROM.
Purpose: This book is intended as a reference for evaluation of children and adolescents when there is concern about sexual abuse, as well as a guide to genital/anal normal/variants
Audience: Written for medical professionals, this book will be most useful to primary care and emergency medical providers and for specialists in child abuse.
Features: The first chapters discuss the broad social issues of child sexual abuse, including its psychological effects, the use of multidisciplinary teams and the workings of the government child protection system. Technical chapters focus on interviewing, forensic evidence collection, physical examination, and sexually transmitted diseases in children. The last chapter is directed towards the medical clinician testifying as an expert witness. The most original aspect of this text is the interactive CD-ROM that is included with the book. The CD-ROM has four sections, beginning with the complete text and images from the book. Following are 28 "Interactive Clinical Consultations" which require the user to choose tentative diagnoses, laboratory tests, and treatment. These cases are linked to text about the medical diagnoses. The third section, "Interactive Case Studies," requires the user to collect needed information and then write a forensic report. The fourth section presents 30 brief case histories for visual diagnosis of normal and traumatic findings and other pathology. Much of the medical information on the CD-ROM is not included in the text. The book suffers from poor copyediting: 65 pages of photographs are not numbered, complicating finding the photograph of an indexed condition.
Assessment: Despite these limitations, this book is the most extensive reference on this subject. The combination of a reference text, photographic atlas, and a computer program for training is valuable for all primary care and emergency medical providers who wish to increase their expertise in pediatric gynecology and diagnosing abuse. Residents will find the CD-ROM an excellent study aid. Emergency departments and training settings for pediatrics, family practice, and emergency medicine should make room on their shelves for this reference. Clinicians who evaluate abused children will often refer to this essential volume.