Your 12-year-old patient complains of pelvic discomfort,which she states is the result of injuries from riding a horse.Your assessment of a patient reveals bruising of the mons pubis and labia.Which additional finding is the strongest evidence that the patient has been sexually abused?

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Physical signs of sexual abuse include bruising of the mons pubis,labia,or perineum,and vaginal or rectal tears.Emotional signs,such as lack of eye contact and extreme anxiety or guarding during the assessment,or refusing to assume certain positions,can all indicate a history of abuse.However,the presence of a sexually transmitted disease (STD)such as genital herpes in the very young or the very old patient is the strongest evidence for sexual abuse.Vaginal infection is not an STD,nor is a urinary tract infection.

Your 12-Year-Old Patient Complains of Pelvic Discomfort,which She States Is