An 18-month-old child was brought to the emergency department by his mother with extensive bruising of genitalia and inability to urinate. His mother stated that he fell from the jungle gym and had a straddling injury (Images 56a-e). https://s3-euw1-ap-pe-df-pch-content-public-u.s3.eu-west-1.amazonaws.com/9780429170423/236ca68c-f283-4df8-88b2-3b8ff49bccc9/content/fig56a.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/> https://s3-euw1-ap-pe-df-pch-content-public-u.s3.eu-west-1.amazonaws.com/9780429170423/236ca68c-f283-4df8-88b2-3b8ff49bccc9/content/fig56b.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/> https://s3-euw1-ap-pe-df-pch-content-public-u.s3.eu-west-1.amazonaws.com/9780429170423/236ca68c-f283-4df8-88b2-3b8ff49bccc9/content/fig56c.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/> https://s3-euw1-ap-pe-df-pch-content-public-u.s3.eu-west-1.amazonaws.com/9780429170423/236ca68c-f283-4df8-88b2-3b8ff49bccc9/content/fig56d.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/> https://s3-euw1-ap-pe-df-pch-content-public-u.s3.eu-west-1.amazonaws.com/9780429170423/236ca68c-f283-4df8-88b2-3b8ff49bccc9/content/fig56e.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/>
Is the explanation plausible?
What is the key element in the photos to prove or disprove the explanation?
What is the aetiology of this patient’s presentation?
A straddling injury is not a consistent explanation for this injury, as it would not remove epithelium from the glans penis. These injuries are due to oral sexual assault. ii. There are subtle injuries to the epithelium of both thighs, with slight bruising.
While friction and abrasion injuries have been described in physical torture, 1 the aetiology of the thigh injuries in this case is rubbing from the whiskers of the assailant, also known as ‘whisker burn’. A careful examination is essential in the presence of dramatic injuries to ensure important subtle injuries, i.e. the thighs, are not overlooked.