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Heppenstall-Heger et al. (2003) prospectively studied 94 cases of sexual abuse of girls involving penetration over a period of 10 years and found hymenal injuries in 37 cases (32). 15 complete hymenal tears were still demonstrable on follow-up examination. In contrast, partial tears, hematomas, and abrasions healed fully, without exception. Anal injuries healed fully in 29 of 31 cases; scarring was seen in only 2 cases. In a case-control study by Berenson et al. (2000), involving 192 3- to 8-year-old sexually abused girls and a carefully selected control group, only minor differences in the anogenital findings were seen; 5% had suggestive evidence of abuse, and 2.5% had definitive evidence of abuse (33). The types of definitive evidence include deep or complete posterior notching of the hymen, perforations, acute tears of the vulva, and ecchymoses. Superficial hymenal notching was seen in both groups (34). 2b1af7f3a8