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Forensic Radiography
 

Forensic Radiography

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  • Post-mortem examination. an examination of the body made after the death of the patient; an autopsy
  • The contrast medium must be introduced into the wound by gravity and not injected as pressure could from false channels.
  • > 1st pt. formation—both visibility and sharpness of details.The radiographer should remember that kVp controls penetration and scale of contrast. mAs controls density. Why? Because decomposition, loss of tissue & gas will affect techniqueCR, every effort should be taken to to improve image quality, including increased FFD, small focal spot, close collimation, optimal (kVp), and sufficient (mAs) to make detail visible.
  • in Mass Fatality Events ,Radiographer is usually a member of a formal forensics team.
  • Although the radiographer may not be directly involved in the collection and preservation of evidence

Forensic Radiography Forensic Radiography Presentation Transcript

  • ForensicRadiography
    Done by:
    Alaa Al-Angary
    Noura Al-Anazi
    Shatha Al-Mushayt
    Presented by:
    Shatha Al-Mushayt
    • History
    • Definition
    • Modalities
    • Using Medical Imaging in Forensic Science
    • Projections
    • Radiographer 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
  • General X-ray:
    Shard of glass (arrows) from
    a broken beer bottle remain in the
    lung of this stabbing victim.
    Fluoroscopy:
    Post-operative chest x-ray and
    intra-bronchial contrast material
    with initial tracheal stent in place.
    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 should
    have been emptied before the scan was done.
    CT:
    Recently, more popular
    Why?
    •  Time , cost
    • Improved scan quality
    • Some says that CT will replace other modalities in forensic radiology.
    http://www2.le.ac.uk/departments/emfpu/imaging/brief-history
  • 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 head
    Injuries (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 purposes
    93% rate for identification of subjects from dental radiographs.
    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:
    A darkening in the crown (arrow);
    Tooth 32 occlusal destruction of crown.
    Dental Radiography:
    for identification and ageing purposes
    93% rate for identification of subjects from dental radiographs.
    PDF)The use of clinical CCT images in the forensic examination of closed head
    Injuries (M.Bauer ,S. polzin, D.patzelt)
  • Angiography and venography:
    For determining blood flow although it is
    not common.
    Cerebral angiogram demonstrates small, acute stroke
    (arrowhead) in internal capsule – thalamic junction.
    • Used to detect intracranial and intraventricular bleeding.
    • It is possible that this may also be used post-mortem.
    Bilateral intraventricularhaemorrhage: enlarged lateral ventricles
    with oval contours. Macrogranular choroid vascular plexuses show a large textured cohesion. Visible enlarged thirdventricle with a diameter of 7-8 mm.
    THE USE OF RADIOGRAPHY IN FORENSIC MEDICINE (Nigel Hughes and Mary Baker )
    http://www.czytelniamedyczna.pl/new_medicine-92
  • Using Of Forensic Radiology
    Widely used in:
    Identification
    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.
    Age
    Gender
    Race
    The comparison of ante & post mortem radiographs is one of the most accurate means of identification.
    Forensic Radiology by B. G. Brogdon, M.D.
  • A. Identification
    Age
    Child: by the appearance of centers of ossification for hand and wrist.
    Young adult: by the state of fusion of epiphyses.
    Race
    Images basically for skull.
    Skeletal racial Groups:
    Negroid – elongated cranium
    Mongoloid – rounded cranium
    Caucasoid- Head is curved at the top, not
    completely flat, The chin is prominent.
    Forensic Radiology by B. G. Brogdon, M.D.
  • 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.
    SKULL
    F, more vertical forehead
    M, less rounded forehead
  • 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.
    SKULL
    F, more vertical forehead
    M, less rounded forehead
    PELVIS
    F, larger & more round
    M, more oval
  • 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.
    LONG BONES
    F, shorter & thinner
    M, longer & thicker
  • 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.
    A: male pelvis. B: female pelvis
  • 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.
    A: male pelvis. B: female pelvis
  • B. Cause of death
    Foreign bodies location
    Demonstration of tracks
    Demonstration of injuries or disease
    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
  • Cont. Foreign bodies
    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
    Supine chest radiograph showing bullet (arrow) from acute gunshot wound.
    Forensic Radiology by B. G. Brogdon, M.D.
  • Demonstration of injuries or diseases
    e.g. The identification of old or multiple fractures (new # is more bright)
    Child abuse
    To identify the extent ofphysical injury
    To clarify all imaging findings that point to alternative diagnoses
     
    This fracture was caused by a twisting force or torsion at the hands of an adult caregiver.
    Sever hand fractures in young male
    http://www.flickr.com/photos/roentgenator/1435208683/
  • Projections
     
    digits PA projection
    for bone age evaluation.
    skulltrue AP & lat. projections
    the frontal sinuses &the Sellaturcica can provide unique markers in ID.
    Entire body (for identification)everyjoint must be included
    because orthopedic appliances or unique degenerative changes aid the ID process.
    Correct anatomical markers within the collimated light field is critical.
    Forensic Radiology by B. G. Brogdon, M.D.
  • 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
    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.
    http://www.eradimaging.com/site/article.cfm?ID=657&mode=ce
  • 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.
    http://www.eradimaging.com/site/article.cfm?ID=657&mode=ce
  • Conclusion
     
    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 and
    technologist.
  • 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=559
    Forensic 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