ABSTRACT
Many vulvovaginal disorders can be diagnosed on history in conjunction with a good physical examination of the external genitalia. Examination in the frog-leg or knee-chest position will allow inspection of the external genitalia, the hymen and lower third of the vagina in prepubertal children. Genital trauma can occur because of various mechanisms: straddle, penetrating, burn, abduction, crush or water-jet injury. The mechanism of genital injury described by either a verbal child or their caretaker should be plausible, timely and most importantly consistent with the findings evident on physical examination. A lack of correlation between the history and physical findings is an indication to consider a sexual abuse evaluation. The differential diagnosis of pelvic pain in children and adolescents is gynaeco-logical and non-gynaecological. History and physical examination should guide the investigation and management. In the adolescent age group it is important to consider complications of sexual activity in the differential diagnosis of abdominal pain.
