POPPI Worthington's injuries were the subject of a strong challenge as the doctor who first raised concerns was cross examined in court.

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EVIDENCE: Home Office pathologist Dr Alison Armour leaves Liverpool Civil and Family Courts after a hearing into the death of 13-month-old Poppi Worthington. Credit Peter Byrne/PA Wire Dr Alison Armour conducted the post-mortem and maintained throughout that her findings pointed to "penetrative sexual assault" as causing the injuries.

During yesterday's hearing at Liverpool Family Court, looking solely at the medical evidence in the case, the lawyer representing Poppi's father - who was sat in court - challenged Dr Armour's findings and cited the evidence of other experts who came to different conclusions after reviewing the same evidence.

On admission to hospital and at post-mortem, the youngster was found to have an earlier fracture of her right lower leg and suspected acute injuries in the region of the anus.

Dr Armour was first quizzed about her "hypothesis of penetrative anal assault" by Janet Bazley QC, for the Children's Guardian - a court appointed legal official, who asked the doctor if her opinion of the injuries had changed, following further review by other doctors.

But Dr Armour said her professional opinion had not changed and she maintained her original opinion.

Jane Cross QC, representing Cumbria County Council, said: "We know that Poppi was heard to scream or cry out loud and that about 10 minutes after that she was found by her father in a collapsed state and thereafter there were a number of reported sightings of blood around and emanating from her anus."

Miss Cross said, without some form of disease present, the cause of the bleeding "is likely to be some sort of trauma."

But two other doctors, yet to give evidence in court - Dr Nat Cary and Dr Liina Kiho, challenged Dr Armour's findings.

But Dr Armour again, after reviewing the evidence, still maintained her position.

Miss Cross said Dr Cary suggested that the bleeding seen from the girl's backside could be a "post mortem" phenomena - occurring after death, not caused by injuries before death.

Dr Armour replied: "I have great difficulty with that hypothesis." 

Karl Rowley QC, representing Poppi's father, said three other medical experts had reviewed the evidence and concluded there was no evidence of Poppi suffering a sexual assault and no evidence of her death being "non-natural". 

Mr Rowley, questioning the witness, continued: "You accept they may be right? Your interpretation maybe wrong." 

"Yes," Dr Armour replied. She continued: "My opinion, sir, has been based on fact, and it is not just one or two facts, it is a number of facts. 

"I have formed my opinion at great length sir, and I'm still confident in my opinion despite the fact that others disagree. "The rapidity of this child's death needs to be addressed."