Publications [#271551] of Elizabeth J. Costello

Journal Articles

1. Costello, EJ (1986). Primary care pediatrics and child psychopathology: a review of diagnostic, treatment, and referral practices.. Pediatrics, 78(6), 1044-1051.
   (last updated on 2023/06/01)

   Abstract:
   Toluidine blue dye applied in the perineal area increased the detection of posterior fourchette lacerations. In the sexually abused population, the detection rate of lacerations increased from 10.2% to 30.5%. In sexually abused adolescent patients the detection rate increased from 4% to 28%, and in sexually abused pediatric patients, the detection rate increased from 16.5 % to 33%. In adolescents, posterior fourchette lacerations are not diagnostic of sexual abuse as they were equally common in sexually abused adolescents and sexually active control adolescents. However, in the pediatric aged population, 33% of the sexually abused group had lacerations detected and none of the control patients had lacerations. The presence of posterior fourchette lacerations in children 10 years of age and younger is strongly suggestive of sexual abuse.