forensic radiography

Forensic Radiography

Done by: Alaa Al-Angary Noura Al-AnaziShatha Al-Mushayt

Presented by: Shatha Al-Mushayt

HistoryDefinitionModalitiesUsing Medical Imaging in Forensic Science ProjectionsRadiographer Role

Outline

Forensic Radiology History

Using x-ray to produce images was discovered by Wilhelm Roentgen in 1895.

Only weeks later, the forensic use of x-ray was tested. Helped in convicting an American murderer.

Weeks later, the technique was first used in UK.

http://www2.le.ac.uk/departments/emfpu/imaging/brief-history

Definition ofForensic Radiology It is a specialized area of medical

imaging using radiological techniques to assist physicians and pathologists in matters related to the law.

Radiographs must be taken before dissection.

Earliest photograph of roentgenography of a cadaver found by the author. http://www2.le.ac.uk/departments/emfpu/imaging/

brief-history

Modalities General X-ray Fluoroscopy NM CT MRI Dental Identification Angiography and venography US

Fluoroscopy:Post-operative chest x-ray and intra-bronchial contrast material with initial tracheal stent in place.

General X-ray:Shard of glass (arrows) from a broken beer bottle remain in the lung of this stabbing victim.

http://www.sahha.gov.mt/pages.aspx?page=559

NM:This is a nuclear scan for died person that dead in isotope environment. It is show some of the isotope is taken up by the kidneys and excreted into the bladder which shouldhave been emptied before the scan was done.

CT: Recently, more popularWhy?• Time , cost • Improved scan quality • Some says that CT will replace other modalities in forensic radiology.


CT image (a) 2 separated fractures in the frontal and temporal bone,(b)

corresponding contusions

Digital superimposition of a hummer with the depressed skull fracture .(PDF)The use of clinical CCT images in the forensic examination of closed headInjuries (M.Bauer ,S. polzin, D.patzelt)

(PDF)The use of clinical CCT images in the forensic examination of closed head Injuries (M.Bauer ,S. polzin, D.patzelt)

MRI:•Used also in FR but has a limited role to play. Why? •The strong magnetic currents required, •costs

Dental Radiography: for identification and ageing purposes93% rate for identification of subjects from dental radiographs.

PDF)The use of clinical CCT images in the forensic examination of closed headInjuries (M.Bauer ,S. polzin, D.patzelt)

MRI:•Used also in FR but has a limited role to play. Why? •The strong magnetic currents required, •costs

Dental Radiography: for identification and ageing purposes93% rate for identification of subjects from dental radiographs.

Dental Radiography:A darkening in the crown (arrow);Tooth 32 occlusal destruction of crown.

PDF)The use of clinical CCT images in the forensic examination of closed headInjuries (M.Bauer ,S. polzin, D.patzelt)

•Used to detect intracranial and intraventricular bleeding.• It is possible that this may also be used post-mortem.Bilateral intraventricular haemorrhage: enlarged lateral ventricles with oval contours. Macrogranular choroid vascular plexuses show a large textured cohesion. Visible enlarged third ventricle with a diameter of 7-8 mm.

Angiography and venography:For determining blood flow although it is not common.Cerebral angiogram demonstrates small, acute stroke (arrowhead) in internal capsule – thalamic junction.

THE USE OF RADIOGRAPHY IN FORENSIC MEDICINE (Nigel Hughes and Mary Baker )http://www.czytelniamedyczna.pl/new_medicine-92

http://www.czytelniamedyczna.pl/new_medicine-92

Using Of Forensic Radiology

Widely used in:A. IdentificationB. Establishing cause of death

five bullets, overlying in the skull

Forensic Radiology by B. G. Brogdon, M.D.

A. Identification To bring evidence to help confirm,

determine, or eliminate the identity of both living and dead persons.

1. Age2. Gender3. Race

The comparison of ante & post mortem radiographs is one of the most accurate means of identification.


A. Identification Age

Child: by the appearance of centers of ossification for hand and wrist.

Young adult: by the state of fusion of epiphyses.

RaceImages basically for skull. Skeletal racial Groups:a) Negroid – elongated craniumb) Mongoloid – rounded cranium a) Caucasoid- Head is curved at the top, not completely flat, The chin is prominent.


A. Identification

• Gender Usually the 1st step in ID process. The sexual characteristics

recognizable by radiography begin to appear after puberty.

RT takes Images for the skull, long bones and pelvis.

SKULLF, more vertical

foreheadM, less rounded

forehead

A. Identification




SKULLF, more vertical

foreheadM, less rounded

forehead

PELVISF, larger & more roundM, more oval

A. Identification




LONG BONESF, shorter & thinner M, longer & thicker

A. Identification




A: male pelvis. B: female pelvis

B. Cause of death

1. Foreign bodies location2. Demonstration of tracks3. Demonstration of injuries or

disease 4. Child abuse

Foreign bodies packages of illegal substances objects such as bullets, fragments of glass, explosives

or pieces of broken needles in drug addicts in the soft tissues.

The location of swallowed objects can assist in correlating time of death with possible cause of injury.

foreign body (button battery) in the

proximal esophagus

http://www.rad-club.com/vb/showthread.php?t=26

Demonstration of tracks Tracks made by gun-shot wounds, stab

wounds and bullet wounds Their depth & proximity to vital organs can be

demonstrated by CM

Cont. Foreign bodies

Supine chest radiograph showing bullet (arrow) from acute gunshot wound.


Demonstration of injuries or diseases e.g. The identification of old or multiple

fractures (new # is more bright) Child abuse

To identify the extent of physical injury To clarify all imaging findings that point to

alternative diagnoses

Sever hand fractures in young male

This fracture was caused by a twisting force or torsion at the hands of an adult caregiver.

http://www.flickr.com/photos/roentgenator/1435208683/



Projections digits PA projection

for bone age evaluation.

skull true AP & lat. projections the frontal sinuses &the Sella turcica can provide

unique markers in ID.

Entire body (for identification) every joint must be included because orthopedic appliances or unique

degenerative changes aid the ID process.

Correct anatomical markers within the collimated light field is critical.


Radiographer Role Should has a complete understanding of the

technical factors ; may have to vary greatly from subject to subject.e.g. A dead individual remains may be found from early

soft tissue stages to advanced skeletonization

condition techniqueearly soft tissue stages like on living subjects

very fragmented, or skeletonized

wide exposure latitude and sharp image detail

systems

http://www.eradimaging.com/site/article.cfm?ID=657&mode=ce

Radiographer Role

Obtaining images as close as possible to ante-mortem imaging in AP/PA and lateral projections.

Providing optimal detail & proper visibility of the structures.

All data & identifiers are recorded on the images (date, time, & location). If any data or markers are not visible or correct, the image should be repeated.

Following all confidentiality and ethical standards.


Radiographer Role Must be prepared to work under extreme

environmental conditions, with any type of X-ray equipment (old piece, portable unit, C-arm, mobile CR, and CT scanners)

Safety aspects Adhering to radiation safety protocols . Wear personal protective equipment when

coming into contact with any body fluids exists. during imaging , Image receptors placed in

plastic covers & wiped with antiseptic after use. Completed & up-to-date vaccinations for

Personnel. http://www.eradimaging.com/site/article.cfm?

ID=657&mode=ce

Radiographer Role Collection and Preservation of Evidence

Radiographer needs to be familiar with certain procedures.

Keep any artifacts that could become evidence. e.g. never throw away any articles of clothing. Bagged hand; do not remove the bags –done to

keep evidence for gunshot residue and underneath fingernails.

ask questions before removing anything that might be related to the incident.


As radiology equipment continues to develop and more applications are discovered for its use in the field of forensics, so will the role of the radiographer andtechnologist.

Conclusion

THANKS FOR BEING ATTENTIVE !

References:http://www2.le.ac.uk/departments/emfpu/imaging/brief-history http://imagingradiationoncology.advanceweb.com/Editorial/Content/Editorial.aspx?CC=53867 http://www.forensicmag.com/articles.asp?pid=7 http://www.diagnosticimaging.com/conference-reports/ecr2009/article/113619/1386135?verify=0 http://www.eradimaging.com/site/article.cfm?ID=657&mode=ce http://www.flickr.com/photos/roentgenator/1435208683/http://www.sahha.gov.mt/pages.aspx?page=559Forensic Radiology by B. G. Brogdon, M.D. (PDF)The use of clinical CCT images in the forensic examination of closed head Injuries (M.Bauer ,S. polzin, D.patzelt) (PDF)THE USE OF RADIOGRAPHY IN FORENSIC MEDICINE (Nigel Hughes and Mary Baker)http://www.rad-club.com/vb/showthread.php?t=26

References


http://imagingradiationoncology.advanceweb.com/Editorial/Content/Editorial.aspx?CC=53867

http://imagingradiationoncology.advanceweb.com/Editorial/Content/Editorial.aspx?CC=53867

http://www.forensicmag.com/articles.asp?pid=7

http://www.diagnosticimaging.com/conference-reports/ecr2009/article/113619/1386135?verify=0

http://www.diagnosticimaging.com/conference-reports/ecr2009/article/113619/1386135?verify=0



forensic radiography

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