Table 4.

Penn Injury Classification System (PICS): A Proposed Genital Injury Classification for Genital and Non-Genital Injury Resulting from IPV and SV

Classification	Genital Injury	Non-Genital Injury
Anatomic Location	External genitalia Internal genitalia Anus and rectum	Head-face-neck Trunk-buttocks-back Upper extremities Lower extremities
Grade I	Redness, swelling Bruising and/or abrasions < 5 mm in size Superficial skin injury of any type (see Table 1) < 5mm in size	Redness, swelling Bruising and/or abrasions < 5 mm in size Superficial skin injury of any type (see Table 1) < 5mm in size
Grade II	Lacerations < 25 mm* in size that do not require suturing Bruising and/or abrasions ≥ 5 mm and ≤ 25 mm* Superficial skin injury of any type (see Table 1) ≥ 5 mm or more in size	Lacerations < 25 mm* in size that do not require suturing Bruising and/or and abrasions ≥ 5 mm and covering ≤ 25% of body surface area Superficial skin injury of any type (see Table 1) ≥ 5 mm or more in size
Grade III	Lacerations that require suturing or are > 25 mm in size* Bruising and/or abrasions > 20 mm	Lacerations that require suturing or are > 25 mm in size* Bruising and/or abrasions covering > 25% of body surface area Bone fractures Evidence of attempted strangulation or choking Internal organ contusion (bruising) or concussion (organ damage from violent blow)

^*From Hilden M, Schei B, Sidenius K. Genitoanal injury in adult female victims of sexual assault. Forensic Science International. 2005;154(2-3):200-205.