The Child Abuse Atlas. Online reference.

Developed in collaboration with:

  • John McCann, MD
  • David Kerns, MD
Meet the Team

The Child Abuse Atlas uses over 1200 images and 600 actual cases to illustrate 150 topics in Child and Adolescent Sexual Abuse. Topics include cases depicting Normal Anatomy, Congenital and Developmental Variations, Trauma and Non-traumatic findings. Over two dozen video animations help visualize the healing process.

The Child Abuse Atlas includes Evidentia Publishing's Child Abuse Evidence database with the best available and highest quality publications on all aspects of Child Maltreatment. We have linked these references to the cases to provide you with easy access to the most relevant current research. All references have received an “Evidence Rating” and we will always show you the articles with the highest level of evidence first.

About the Atlas

The Child Abuse Atlas was created as an educational resource for the full spectrum of professionals working with the difficult and complex problem of child sexual abuse. Every effort has been made to provide broad and deep technical content for medical and nursing professionals, with ‘friendliness’ and translatability for non-medical professionals such as attorneys, social workers and law enforcement personnel. The case material was selected from our clinical experience over the past two decades and was drawn from over 8,000 cases.

Our intention was to create an easy-to-use resource, allowing flexible navigation between topics, cases with photographs and clinical descriptions, glossary definitions with audio pronunciations, and literature references. A full spectrum of anatomic findings is presented. These include normal anatomy, variations of normal, abnormal findings and findings that mimic abuse. Anatomic changes caused by hormonal influence and sexually transmitted diseases are also included. In most instances the findings are demonstrated using the multi-method examination approach, i.e. cases where more than one examination technique was applied. Anatomic changes over time are documented. To assist in the visualization of the continuity of these changes, a technology called “morphing” has been utilized.

The photographs in some instances have been enhanced in terms of sharpness of focus, color correction and cropping, but in no instance has any photograph been modified to alter the actual anatomic characteristics. In the morphed cases, computer animation has been used to visualize the intermediate stages between the photographs that were taken serially at each follow-up visit. Through this process the effect of time-lapse photography was achieved. As with all the other photographs, the connecting images have not been altered in terms of anatomic characteristics.

The search for anatomic changes that may be used as evidence of child sexual abuse is but one component in the evaluation of these cases. The assessment of allegations must remain a multi-disciplinary task that includes a comprehensive investigation of the circumstances, an in-depth interview of the child, an appraisal of any behavioral changes, and the documentation of all forensic evidence. Our hope is that this Atlas/Reference will assist examiners in refining their anatomic diagnostic acumen, and that it will prove to be of value to non-medical professionals in gaining an understanding of the anatomic aspects of child sexual abuse. Ultimately, having a more accurate appreciation of the anatomical changes that may or may not result from a sexual assault should prove to be of value to all those involved in such cases. This would include the child, his or her family, child protection agencies, law enforcement, the courts and the accused.

  • John J. McCann, M.D., F.A.A.P.
  • David L. Kerns, M.D., F.A.A.P.