FORENSIC RADIOLOGY The forensic pathologist’s main duty is the postmortem examination; therefore, he or she deals primarily with Lois Romans, BS, RT (R) (CT) the dead. Because of the managing role of the forensic pathologist, the term forensic medicine is often considered University of Michigan Hospitals synonymous with forensic pathology. Many other medical Ann Arbor, MI specialists, such as forensic dentists and anthropologists, E-mail: [email protected] play an important role on the forensic team, but these professionals are often consultants, working only part- INTRODUCTION time in the field of forensics. The word forensic is derived from the Latin forens, Popular television programs such as CSI: Crime Scene which translates to “public.”3 In Webster’s New World Investigation and Forensic Files have piqued the public’s Dictionary, the word forensics is defined as “characteristic interest in forensic science and put terms such as blood of, or suitable for a law court, public debate, or formal spatter analysis and alternative light source (ALS) into the argument.” Therefore, forensic science applies highly spe- American lexicon. The popularity of these programs cialized scientific and/or technical knowledge to answer attests to the fascinating nature of forensic science. The questions with regard to civil and criminal law. When forensic scientist is, in the truest sense of the word, a medical facts and knowledge are required to deal with detective—solving a mystery, telling a story, and often legal issues, the special discipline is referred to as forensic uncovering a crime. Dr. Gary Telgenhoff, the real-life medicine. In one text, legal medicine is defined as “the medical examiner whose expertise is used by the cre- application of medical knowledge to the administration ators of CSI, explains what attracted him to the field of of law and to the furthering of justice and, in addition, forensic medicine: the legal relations of the medical man.”4 Therefore, in addition forensic pathology, the terms legal medicine, or I liked the combination of the medicine, pathology, medical jurisprudence, may be used synonymously with mystery, challenge and the brand new world of the forensic medicine. courtroom. This required some street smarts, common The definition of forensic medicine is broad, to encom- sense and performance ability. This is the combina- pass the large array of legal issues in which it is applied. tion of all things I was interested in: science, perfor- These include age determination, assault, civil rights vio- mance and a life left at the end of the day.1 lations, inheritance, larceny, malpractice, parentage, per- sonal injury, product liability, sexual offenses, smuggling, Forensic science is a unique scientific discipline requiring virginity, and wrongful birth or death.2 its practitioners to have, in addition to technical skills and Forensic science can be used in civil cases such as forg- knowledge, critical and analytical thinking skills, com- eries, fraud, or negligence. It can help law-enforcement munication skills, and an awareness of the role of the sci- officials determine whether any laws have been violated entist in our criminal justice system. in the marketing of food and drinks, the manufacture of Perhaps one of the appeals of forensics is its wide medicines, or the use of pesticides on crops. It can also array of subspecialties. The American Academy of Forensic determine whether automobile emissions are within a per- Sciences (AAFS) lists nine primary disciplines in the missible level and whether drinking water meets legal field of forensics: criminalistics, engineering sciences, purity requirements. Forensic science is used in monitoring jurisprudence, odontology, pathology/biology, physical the compliance of various countries with such international anthropology, psychiatry/behavioral sciences, questioned agreements as the Nuclear Non-Proliferation Treaty and documents, and toxicology. the Chemical Weapons Convention and to learn whether The multidisciplinary nature of forensic medicine a country is developing a secret nuclear weapons program. necessitates a team approach. The forensic pathologist is However, forensic science is most commonly used to inves- most often the leader of that team and is typically the tigate criminal cases involving a victim, such as assault, only physician devoted full-time to forensic activity.2 robbery, kidnapping, rape, or murder. CEWebSource.com is produced by Enterprises for Continuing Education Inc. (ECEI), PO Box 300, Brighton, MI 48116-0300, (810) 229-3354. The views expressed in the journal are the authors’ and do not necessarily represent those of ECEI. Full and complete pre- scribing information should be reviewed regarding any product mentioned herein prior to use. ECEI hereby authorizes you to copy docu- ments published by ECEI on the World Wide Web for non-commercial use only. In consideration of this authorization, you agree that any copy of these documents which you make shall retain all copyright and other proprietary notices contained herein. FORENSIC radiology CEWEBSOURCE.Com PAGE OF 20 EXPIRES AUGUST 15, 2013 Forensic science is an applied science based on the laws before the onset of a fire.8 of physics and chemistry. Over time, a set of fundamental The development of the medicolegal system of the concepts has developed that apply specifically to a forensic United States can be traced back to the early coroner analysis. Traditionally, five concepts have been enumer- system of England, established in the year 925.6,9 The ated: transfer, identification, individualization, associa- early immigrants to America brought the English cor- tion between source and target, and reconstruction.5 oner system with them. Records of medicolegal cases in the colonies date from 1635. The separate discipline of HISTORICAL DEVELOPMENT forensic medicine began to emerge in the seventeenth century in the United States and throughout the world. Evidence of legal medicine, in one form or another, New codes of law required expert medical testimony in extends throughout human history. Ancient Egyptian trials of certain types of crime or civil action. Textbooks, writings have shown that the scholar, physician, and lectures, and formal educational programs in forensic sci- pyramid architect, Imhotep (2980 BCE) applied medical ences were created. At this time, the earliest version of the principles to legal issues of the day.2 In ancient Babylon modern structure of forensic medicine took shape. This (modern-day Iraq) in approximately 2200 BCE, the king structure is now the multidisciplined, sometimes loosely Hammurabi set formal medical laws into practice. related, family of subspecialties that share the common Another early application of forensic medicine con- interest of using science to solve legal controversies. cerned the determination of suicide in the first cen- tury of the Christian era (CE).6 At the time, suicide History of Forensic Radiology was regarded as a crime against the public interest. It is assumed that this idea stemmed from the primitive The forensic radiologist is an essential member of the belief that the individual who took his or her own life forensic team. Forensic radiology encompasses the per- was possessed by evil spirits that would be passed on to formance, interpretation, and reporting of radiological other members of the community. Because of this belief, examinations and procedures connected to the courts and it was necessary for a medical expert to decide whether the law. By its nature, the science of radiology solves mys- a deceased person committed suicide and should there- teries as it reveals secrets that may be hidden within the fore be punished. (Punishment typically consisted of the body. However, unlike standard diagnostic medical radi- denial of a funeral.) ology, forensic radiology is not limited to the human body. The Germanic and Slavic peoples that overthrew the It has also proven useful in a wide range of nonhuman Roman Empire in Western Europe in the fifth cen- applications, such as uncovering faked art, authenticating tury provide another example of the early practice of antiques, and detecting forged documents. forensic medicine.7 Considered by the rest of Western Soon after Wilhelm Conrad Roentgen discovered the Europe to be barbarian and the destroyers of culture x-ray in 1895, physicians, scientists, jurists, and journal- and civilization, ironically, these tribes (the Salian ists realized the potential Roentgen’s “new kind of ray” Franks, the Alemanni, the Goths, the Vandals, and the might have in legal medicine. In the October 1898 issue Lombards) were the first to specify by law that medical of the American X-ray Journal, Dr. Fovau d’Courmelles experts should be used to determine the cause of death. wrote, “Knowing the existence of a fracture in a person Forbidding the then-common practice of personal ven- who has been burned or mutilated beyond recognition, dettas, these people implemented an established legal we can hope to identify him by the x-ray.”10 system, thereby demanding individual and community In North America, the first court case that uti- responsibility. The Wergeld, or blood-price, was paid to lized x-ray occurred in Montreal on Christmas Eve, the victim by the criminal, or in the case of murder, 1895. In this case, Mr. George Holder was accused of to the victim’s family and relatives. The price assessed shooting Mr. Tolson Cunning in the leg. The bullet depended on the type of injury and on whom the assault could not be found by physical examination or probe. was committed. For example, the fee levied was greater Although the wound healed, it remained symptomatic. if the injured party was of a higher class. The more Mr. Holder’s physician requested that the professor of gruesome the wound, the higher the payment required. physics at McGill University create an image of the For instance, if the wound exposed brain or bowel, the leg using the newly discovered technique of x-ray. A fee was higher than if only blood was shed.