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The difference in frequency of some signs between cases and controls suggest that they are likely to relate to abuse. This makes it possible that examiners in this centre were more likely to detect signs in general, but this would apply to both cases and controls. Allegation of sexual abuse 2. Fissures and laxity were also seen more commonly in cases than controls. An important remaining concern is the possibility of examiner bias. Sexually transmitted infection 6. Anal signs were central in the Cleveland Inquiry [ 28 ] which recommended further study which in turn lead to publications by the Royal College of Physicians which provided guidance for clinicians [ 29 , 30 ]. The sexually abused battered child.

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