A hands-off approach to perineal examination
When examining the perineum of infants or slightly older girls or boys, place the child supine on the table and lift her (his) legs so the knees are close to the face. If the child is old enough, ask her to try to kiss her knees. This maneuver exposes the full perineal area and makes it easy to look for anal tags, fissures, or vaginal discharge or to assess the extent of diaper rash with very minimal touching. Less touching means less apprehension and a quicker, easier examination.
Madhu Desiraju, MDWinter Springs, Fla.
