The physician must obtain appropriate medical/legal information and make the mandatory report of allegations and physical data exist in which the physician reasonably suspects the presence of child sexual abuse, physical abuse, or neglect. An essential duty of the physician is to follow up on medical and mental health needs of the child and the family. The family physician is often the first person to have contact with an abused child, and the initial examination is critical. Photographs in child sexual abuse cases are important but not essential; a good diagram with measurements is a suitable alternative. Physicians must be aware of signs of child sexual abuse, including torn or bloody undergarments, bruises, bleeding or purulent vaginal discharge, and the presence of explicit sexual behavior beyond the child's developmental level. It is important to realize that the full presentation of medical data alone does not substantiate child sexual abuse. 57 references