Sensitivity of autopsy and radiological examination in detecting bone fractures in an animal model: Implications for the assessment of fatal child physical abuse

Performance of post-mortem CT compared to autopsy in children

“…Different studies have demonstrated the superiority of PMCT in detecting fractures, as conventional autopsy does not routinely include examination of the entire skeleton [26]. A similar observation in a pediatric population has already been described by Cattaneo et al, who investigated the use of PMCT to examine bone fractures in cases of child abuse [22].…”

“…Most studies that compared the findings of imaging examinations with those of conventional autopsy included adults only [5,[16][17][18][19]. Moreover, the few studies that evaluated pediatric cases [20,21] were specific to sudden infant [15] or post-traumatic death [22]. Thus, the purpose of this study was to compare the findings of postmortem CT (PMCT) with those of forensic conventional autopsy in a group of children who died of different causes and evaluate its potential usefulness in non-medicolegal situations.…”

Forensic radiology and personal identification of unidentified bodies: a review

“…Sebbene la virtopsy non possa sostituire la classica procedura autoptica, il contributo di tali tecnologie avanzate può fornire decisive informazioni per l'analisi delle lesioni e l'identifi cazione personale. Inoltre, l'importanza dell'approccio radiologico è provata anche dalla sua diffusione come fondamentale test diagnostico nel caso di abusi fi sici su bambini, ove l'accertamento della presenza di segni di traumatismi recenti e pregressi è di fondamentale importanza [38,39] [41][42][43], specialmente in specifi ci distretti vertebrali quali le vertebre [44]. Al momento il tema della precisione ed accuratezza dell'indagine radiografi ca è un punto cruciale di dibattito e dovrebbe essere approfondito per verifi care la sua reale affi dabilità nel campo dell'identifi cazione personale.…”

“…The most important limitation, however, consists in the reliability of X-ray imaging, which is widely debated by different authors, especially in the fi eld of the analysis and description of lesions. Different authors have in fact remarked that CT and X-ray examinations can detect only a limited percentage of skeletal traits or lesions if compared with the evidence gained from autopsy or after maceration of bones [41][42][43], especially in specifi c skeletal districts such as the vertebrae [44]. The issue of precision and accuracy of X-ray technologies is a relevant point of debate and should be analysed in depth to ascertain whether such technologies are reliable in personal identifi cation.…”

Case report: Forensic anthropological assessment in a suspected case of child abuse from South Africa

“…Cattaneo et al [23] illustrated that it may be difficult to visualize fractures, and that several diagnostic approaches are needed. In their study the sensitivity of autopsy, radiology and CT-scanning to detect fractures in a pig sample was investigated.…”