title: The relationship between the transverse hymenal orifice diameter by the separation technique and other possible markers of sexual abuse.
abstract: OBJECTIVE
  To evaluate the relationship between the transverse hymenal orifice diameter as measured by separation technique (THODST), using a method that maximized the diameter of the hymenal orifice, and other possible markers of sexual abuse in girls from 3 through 12 years old.
  
  
  METHODS
  Over a 10-year period, clinical information was recorded on girls referred to the WakeMed Child Sexual Abuse Team in Raleigh, NC at the time of examination. The study population comprised 1975 girls of the 2058 evaluated for sexual abuse. The girls were interviewed, examined, and tested for sexually transmitted diseases. Information from referral sources, accompanying guardians, and previous recent physical examinations was recorded. The girls were assigned to three groups based upon their risk of being sexually abused. Linear regression was performed to evaluate how well the THODST distinguished between the risk groups, as well as how it was correlated with individual established markers of sexual abuse.
  
  
  RESULTS
  The size of the THODST did not distinguish between the three risk groups, nor did it correlate with any potential or established markers of sexual abuse other than three potential markers of hymenal trauma: narrowing of the posterior hymenal rim, hymenal tears and lacerations, and hymenal clefts between 5 and 7 o'clock in the supine position.
  
  
  CONCLUSIONS
  Thus, we found the THODST as we measured it to have no value for answering the question, "Was this child sexually abused?"
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Ingram
authors.forename: V D
authors.initials: VD
authors.lastname: Everett
authors.forename: D L
authors.initials: DL
authors.lastname: Ingram
mesh_terms: D015415:Biomarkers; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis*; D002675:Child, Preschool; D003075:Coitus / Q000502:physiology; D005260:Female; D005554:Forensic Medicine / Q000379:methods*; D006801:Humans; D006924:Hymen / Q000293:injuries*; D016014:Linear Models; D009657:North Carolina; D010808:Physical Examination / Q000379:methods*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis
chemical_list: D015415:Biomarkers