Bone scintigraphy as clue to previous torture

Lok, Veli; Tunca, Mehmet; Kumanlıoğlu, Kamil; Kapkin, Emre; Dirik, Gürkan

doi:10.1016/0140-6736(91)92548-g

Cited by 25 publications

(6 citation statements)

References 3 publications

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“…A reduction of the elasticity of the heel pads has also been proposed [11]. In single cases, fractures of metatarsal bones and aseptic bone necrosis have been reported [14,15]. …”

Section: Introductionmentioning

confidence: 99%

Sensory functions in the foot soles in victims of generalized torture, in victims also beaten under the feet (falanga) and in healthy controls – A blinded study using quantitative sensory testing

Prip

Persson²,

Sjölund

2012

BMC Int Health Hum Rights

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BackgroundFalanga torture (beatings on the foot soles) produces local chronic pain and severe walking difficulties. We have previously reported signs of neuropathic pain in the feet of falanga victims. The objective here was to clarify underlying pain mechanisms by quantifying sensory impairments in the feet of torture victims who had experienced both generalized torture and those who had been exposed to falanga in addition. An ethnically matched control group was available.MethodsWe employed quantitative sensory testing (QST) by investigators blinded to whether the patients, 32 male torture victims from the Middle East, had (n=15), or had not (n=17) been exposed to falanga. Pain intensity, area and stimulus dependence were used to characterize the pain as were interview data on sensory symptoms. QST included thresholds for touch, cold, warmth, cold-pain, heat-pain, deep pressure pain and wind-up to cutaneous noxious stimuli in the foot soles. Clinical data on anxiety and depression were retrieved.ResultsAlmost all falanga victims had moderate or strong pain in their feet and in twice as large an area of their foot soles as other torture victims. One-third of the latter had no pain in their feet and many reported slight pain; in spite of this, there were no differences in foot sole QST data between the tortured groups. A comparison with normal data indicated that both tortured groups had hypoesthesia for all cutaneous sensory fibre groups except those transmitting cold and heat pain, in addition to deep mechano-nociceptive hyperalgesia.ConclusionA comparison of the QST data between victims having been exposed to generalized torture and victims who in addition had been exposed to falanga, showed no differences on the group level. The sensory disturbances in relation to our control group are compatible with central sensitization and de-sensitization, pointing to a core role of central mechanisms. A further analysis to create individual sensory profiles from our measurements is in progress.

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“…A reduction of the elasticity of the heel pads has also been proposed [11]. In single cases, fractures of metatarsal bones and aseptic bone necrosis have been reported [14,15]. …”

Section: Introductionmentioning

confidence: 99%

Sensory functions in the foot soles in victims of generalized torture, in victims also beaten under the feet (falanga) and in healthy controls – A blinded study using quantitative sensory testing

Prip

Persson²,

Sjölund

2012

BMC Int Health Hum Rights

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“…Bone scintigraphy was performed for all three cases but no increase in osteoblastic activity indicative of continuing healing was detected. Previous studies show that bone scintigraphy detected traumatic hyperactivity on bone areas with trauma history of 2, 12, and even 25 years [35][36][37][38]. Nevertheless no traumatic hyperactivity in bone scintigraphy is considered normal given the long elapse of time.…”

Section: Discussionmentioning

confidence: 94%

“…Repeated, severe and prolonged torture methods (such as phalanga, suspension, beating) might cause periost reaction and occult fractures [35,36]. Bone scintigraphy was performed for all three cases but no increase in osteoblastic activity indicative of continuing healing was detected.…”

Section: Discussionmentioning

confidence: 99%

“…Bone scintigraphy as a diagnostic method is recommended for trauma that took place a long time ago, which might have periost injuries or occult fractures that cannot be clinically or radiologically detected [6,[35][36][37][38]. Repeated, severe and prolonged torture methods (such as phalanga, suspension, beating) might cause periost reaction and occult fractures [35,36].…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis of torture after 32 years: Assessment of three alleged torture victims during the 1980 military coup in Turkey

Göçeoğlu¹,

Ulaş

Fincancı

2014

Forensic Science International

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“…Bone scintigraphy has been reported to be especially efficient in recognising and documenting blunt bone injuries after torture [41,42], as also in child abuse and should be considered [43], especially if injuries are related to reported torture that was afflicted not longer than a about decade ago (Table 1). In this context, it is important to keep in mind, that a negative finding must not disprove details in reports of alleged torture, especially as memory can be unreliable due to factors like disorientation during torture, blunt brain injury, (posttraumatic) stress related disorder, or other disorders leading to impaired memory and concentration like also for example diabetes [17,44,45].…”

Section: Introductionmentioning

confidence: 99%

The role of surgeons in the medical documentation of torture- UN standards

Wenzel¹,

Alksiri²,

Mirzaei³

et al. 2021

Sur Res J

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Rationale: In the article, the authors present the relevance of the frequently neglected UN and World Medical Association standard for the documentation of torture related injuries, the Istanbul protocol. Objectives: We aim at summarising the relevant key aspects of this important standard for surgeons in preserving evidence and fulfilling their ethical obligations as medical doctors. We find the instrument clear and relevant and highlight the need of an interdisciplinary approach in the documentation and prevention of torture. Conclusions: The Istanbul protocol is an important standard that should be known and used in clinical practice whenever confronted with possible or alleged sequels to torture an can also improve the understanding of often underrated forensic procedures and the possible contribution of their field for surgeons and other health professionals, not only for forensic experts.

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Bone scintigraphy as clue to previous torture

Cited by 25 publications

References 3 publications

Sensory functions in the foot soles in victims of generalized torture, in victims also beaten under the feet (falanga) and in healthy controls – A blinded study using quantitative sensory testing

Sensory functions in the foot soles in victims of generalized torture, in victims also beaten under the feet (falanga) and in healthy controls – A blinded study using quantitative sensory testing

Diagnosis of torture after 32 years: Assessment of three alleged torture victims during the 1980 military coup in Turkey

The role of surgeons in the medical documentation of torture- UN standards

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