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

    1. 1. ForensicRadiography<br />Done by: <br />Alaa Al-Angary<br />Noura Al-Anazi<br />Shatha Al-Mushayt<br />Presented by: <br />Shatha Al-Mushayt<br />
    2. 2. <ul><li>History
    3. 3. Definition
    4. 4. Modalities
    5. 5. Using Medical Imaging in Forensic Science
    6. 6. Projections
    7. 7. Radiographer Role</li></ul>Outline<br />
    8. 8. Forensic Radiology History<br />Using x-ray to produce images was discovered by Wilhelm Roentgen in 1895. <br /> Only weeks later, the forensic use of x-ray was tested.<br />Helped in convicting an American murderer.<br />Weeks later, the technique was first used in UK.<br />http://www2.le.ac.uk/departments/emfpu/imaging/brief-history<br />
    9. 9. Definition ofForensic Radiology<br />It is a specialized area of medical imaging using radiological techniques to assist physicians and pathologists in matters related to the law. <br />Radiographs must <br /> be taken before dissection. <br />Earliest photograph of roentgenography of a cadaver found by the author.<br />http://www2.le.ac.uk/departments/emfpu/imaging/brief-history<br />
    10. 10. Modalities<br />General X-ray <br />Fluoroscopy<br />NM<br />CT<br />MRI<br />Dental Identification<br />Angiography and venography<br />US <br />
    11. 11. General X-ray:<br />Shard of glass (arrows) from<br /> a broken beer bottle remain in the <br />lung of this stabbing victim.<br />Fluoroscopy:<br />Post-operative chest x-ray and<br /> intra-bronchial contrast material<br /> with initial tracheal stent in place.<br /> http://www.sahha.gov.mt/pages.aspx?page=559<br />
    12. 12.  <br /> NM:<br />This is a nuclear scan for died person that dead in isotope <br /> environment. It is show some of the isotope is taken up by <br />the kidneys and excreted into the bladder which should<br />have been emptied before the scan was done. <br />CT: <br />Recently, more popular<br />Why?<br /><ul><li>  Time , cost
    13. 13. Improved scan quality
    14. 14. Some says that CT will replace other modalities in forensic radiology.</li></ul>http://www2.le.ac.uk/departments/emfpu/imaging/brief-history<br />
    15. 15. CT image (a) 2 separated fractures in the frontal and temporal bone,(b) corresponding contusions<br />Digital superimposition of a hummer with the depressed skull fracture .<br />(PDF)The use of clinical CCT images in the forensic examination of closed head<br />Injuries (M.Bauer ,S. polzin, D.patzelt)<br /> <br />(PDF)The use of clinical CCT images in the forensic examination of closed head <br />Injuries (M.Bauer ,S. polzin, D.patzelt) <br />
    16. 16. MRI:<br /><ul><li>Used also in FR but has a limited role to play. Why?
    17. 17. The strong magnetic currents required,
    18. 18. costs</li></ul>Dental Radiography: <br />for identification and ageing purposes<br />93% rate for identification of subjects from dental radiographs. <br />PDF)The use of clinical CCT images in the forensic examination of closed head<br />Injuries (M.Bauer ,S. polzin, D.patzelt)<br />
    19. 19. MRI:<br /><ul><li>Used also in FR but has a limited role to play. Why?
    20. 20. The strong magnetic currents required,
    21. 21. costs</li></ul>Dental Radiography:<br />A darkening in the crown (arrow);<br />Tooth 32 occlusal destruction of crown.<br />Dental Radiography: <br />for identification and ageing purposes<br />93% rate for identification of subjects from dental radiographs. <br />PDF)The use of clinical CCT images in the forensic examination of closed head<br />Injuries (M.Bauer ,S. polzin, D.patzelt)<br />
    22. 22. Angiography and venography:<br />For determining blood flow although it is <br />not common.<br />Cerebral angiogram demonstrates small, acute stroke<br /> (arrowhead) in internal capsule – thalamic junction. <br /><ul><li>Used to detect intracranial and intraventricular bleeding.
    23. 23. It is possible that this may also be used post-mortem.</li></ul>Bilateral intraventricularhaemorrhage: enlarged lateral ventricles <br />with oval contours. Macrogranular choroid vascular plexuses show a large textured cohesion. Visible enlarged thirdventricle with a diameter of 7-8 mm.<br />THE USE OF RADIOGRAPHY IN FORENSIC MEDICINE (Nigel Hughes and Mary Baker )<br />http://www.czytelniamedyczna.pl/new_medicine-92<br />
    24. 24. Using Of Forensic Radiology<br />Widely used in:<br />Identification<br />Establishing cause of death<br />five bullets, overlying in the skull<br />Forensic Radiology by B. G. Brogdon, M.D. <br />
    25. 25. A. Identification<br />To bring evidence to help confirm, determine, or eliminate the identity of both living and dead persons. <br />Age<br />Gender<br />Race<br />The comparison of ante & post mortem radiographs is one of the most accurate means of identification.<br />Forensic Radiology by B. G. Brogdon, M.D. <br />
    26. 26. A. Identification<br />Age <br />Child: by the appearance of centers of ossification for hand and wrist.<br />Young adult: by the state of fusion of epiphyses.<br />Race<br />Images basically for skull. <br />Skeletal racial Groups:<br />Negroid – elongated cranium<br />Mongoloid – rounded cranium <br />Caucasoid- Head is curved at the top, not <br />completely flat, The chin is prominent.<br />Forensic Radiology by B. G. Brogdon, M.D. <br />
    27. 27. A. Identification<br /><ul><li>Gender</li></ul>Usually the 1st step in ID process.<br />The sexual characteristics recognizable by radiography begin to appear after puberty.<br />RT takes Images for the skull, long bones and pelvis.<br />SKULL<br />F, more vertical forehead<br />M, less rounded forehead<br />
    28. 28. A. Identification<br /><ul><li>Gender</li></ul>Usually the 1st step in ID process.<br />The sexual characteristics recognizable by radiography begin to appear after puberty.<br />RT takes Images for the skull, long bones and pelvis.<br />SKULL<br />F, more vertical forehead<br />M, less rounded forehead<br />PELVIS<br />F, larger & more round<br />M, more oval<br />
    29. 29. A. Identification<br /><ul><li>Gender</li></ul>Usually the 1st step in ID process.<br />The sexual characteristics recognizable by radiography begin to appear after puberty.<br />RT takes Images for the skull, long bones and pelvis.<br />LONG BONES<br />F, shorter & thinner <br />M, longer & thicker<br />
    30. 30. A. Identification<br /><ul><li>Gender</li></ul>Usually the 1st step in ID process.<br />The sexual characteristics recognizable by radiography begin to appear after puberty.<br />RT takes Images for the skull, long bones and pelvis.<br />A: male pelvis. B: female pelvis<br />
    31. 31. A. Identification<br /><ul><li>Gender</li></ul>Usually the 1st step in ID process.<br />The sexual characteristics recognizable by radiography begin to appear after puberty.<br />RT takes Images for the skull, long bones and pelvis.<br />A: male pelvis. B: female pelvis<br />
    32. 32. B. Cause of death<br />Foreign bodies location<br />Demonstration of tracks<br />Demonstration of injuries or disease <br />Child abuse <br />
    33. 33. Foreign bodies <br /> packages of illegal substances <br />objects such as bullets, fragments of glass, explosives or pieces of broken needles in drug addicts in the soft tissues. <br />The location of swallowed objects can assist in correlating time of death with possible cause of injury.<br /> foreign body (button battery) in the <br /> proximal esophagus<br />http://www.rad-club.com/vb/showthread.php?t=26<br />
    34. 34. Cont. Foreign bodies <br />Demonstration of tracks<br />Tracks made by gun-shot wounds, stab wounds and bullet wounds <br />Their depth & proximity to vital organs can be demonstrated by CM <br /> Supine chest radiograph showing bullet (arrow) from acute gunshot wound.<br />Forensic Radiology by B. G. Brogdon, M.D. <br />
    35. 35. Demonstration of injuries or diseases<br />e.g. The identification of old or multiple fractures (new # is more bright)<br />Child abuse <br />To identify the extent ofphysical injury<br />To clarify all imaging findings that point to alternative diagnoses<br /> <br />This fracture was caused by a twisting force or torsion at the hands of an adult caregiver.<br />Sever hand fractures in young male<br />http://www.flickr.com/photos/roentgenator/1435208683/<br />
    36. 36. Projections<br /> <br />digits PA projection <br />for bone age evaluation. <br />skulltrue AP & lat. projections <br />the frontal sinuses &the Sellaturcica can provide unique markers in ID. <br />Entire body (for identification)everyjoint must be included <br />because orthopedic appliances or unique degenerative changes aid the ID process. <br />Correct anatomical markers within the collimated light field is critical. <br />Forensic Radiology by B. G. Brogdon, M.D. <br />
    37. 37. Radiographer Role<br />Should has a complete understanding of the technical factors ; may have to vary greatly from subject to subject.<br />e.g. A dead individual remains may be found from early soft tissue stages to advanced skeletonization<br />http://www.eradimaging.com/site/article.cfm?ID=657&mode=ce<br />
    38. 38. Radiographer Role<br />Obtaining images as close as possible to ante-mortem imaging in AP/PA and lateral projections.<br />Providing optimal detail & proper visibility of the structures.<br />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.<br />Following all confidentiality and ethical standards. <br />http://www.eradimaging.com/site/article.cfm?ID=657&mode=ce<br />
    39. 39. Radiographer Role<br />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)<br />Safety aspects<br />Adhering to radiation safety protocols .<br />Wear personal protective equipment when coming into contact with any body fluids exists. <br />during imaging , Image receptors placed in plastic covers & wiped with antiseptic after use. <br />Completed & up-to-date vaccinations for Personnel.<br />http://www.eradimaging.com/site/article.cfm?ID=657&mode=ce<br />
    40. 40. Radiographer Role<br />Collection and Preservation of Evidence Radiographer needs to be familiar with certain procedures.<br />Keep any artifacts that could become evidence.<br />e.g. never throw away any articles of clothing. <br />Bagged hand; do not remove the bags –done to keep evidence for gunshot residue and underneath fingernails.<br />ask questions before removing anything that might be related to the incident.<br />http://www.eradimaging.com/site/article.cfm?ID=657&mode=ce<br />
    41. 41. Conclusion<br /> <br />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<br />technologist.<br />
    42. 42. Thanks for being attentive ! <br />
    43. 43. References:<br />http://www2.le.ac.uk/departments/emfpu/imaging/brief-history<br />http://imagingradiationoncology.advanceweb.com/Editorial/Content/Editorial.aspx?CC=53867<br />http://www.forensicmag.com/articles.asp?pid=7<br />http://www.diagnosticimaging.com/conference-reports/ecr2009/article/113619/1386135?verify=0<br />http://www.eradimaging.com/site/article.cfm?ID=657&mode=ce<br />http://www.flickr.com/photos/roentgenator/1435208683/<br />http://www.sahha.gov.mt/pages.aspx?page=559<br />Forensic Radiology by B. G. Brogdon, M.D. <br />(PDF)The use of clinical CCT images in the forensic examination of <br />closed head Injuries (M.Bauer ,S. polzin, D.patzelt) <br />(PDF)THE USE OF RADIOGRAPHY IN FORENSIC MEDICINE<br />(Nigel Hughes and Mary Baker)<br />http://www.rad-club.com/vb/showthread.php?t=26<br />References<br />

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