Postmortem Radiographs Research Articles

ISOLATION AND CHARACTERIZATION OF A NOVEL MARINE BRUCELLA FROM A SOUTHERN SEA OTTER (ENHYDRA LUTRIS NEREIS), CALIFORNIA, USA.

We characterize Brucella infection in a wild southern sea otter ( Enhydra lutris nereis) with osteolytic lesions similar to those reported in other marine mammals and humans. This otter stranded twice along the central California coast, US over a 1-yr period and was handled extensively at two wildlife rehabilitation facilities, undergoing multiple surgeries and months of postsurgical care. Ultimately the otter was euthanized due to severe, progressive neurologic disease. Necropsy and postmortem radiographs revealed chronic, severe osteoarthritis spanning the proximal interphalangeal joint of the left hind fifth digit. Numerous coccobacilli within the joint were strongly positive on Brucella immunohistochemical labelling, and Brucella sp. was isolated in pure culture from this lesion. Sparse Brucella-immunopositive bacteria were also observed in the cytoplasm of a pulmonary vascular monocyte, and multifocal granulomas were observed in the spinal cord and liver on histopathology. Findings from biochemical characterization, 16S ribosomal DNA, and bp26 gene sequencing of the bacterial isolate were identical to those from marine-origin brucellae isolated from cetaceans and phocids. Although omp2a gene sequencing revealed 100% homology with marine Brucella spp. infecting pinnipeds, whales, and humans, omp2b gene sequences were identical only to pinniped-origin isolates. Multilocus sequence typing classified the sea otter isolate as ST26, a sequence type previously associated only with cetaceans. Our data suggest that the sea otter Brucella strain represents a novel marine lineage that is distinct from both Brucella pinnipedialis and Brucella ceti. Prior reports document the zoonotic potential of the marine brucellae. Isolation of Brucella sp. from a stranded sea otter highlights the importance of wearing personal protective equipment when handling sea otters and other marine mammals as part of wildlife conservation and rehabilitation efforts.

Panoramic radiograph as a clue for human identification: A forensic case report

Forensic odontology works in the interface between dentistry and law. Human identification is an important procedure performed by Forensic Dentists. The present study reports a case of dental human identification of a highly decomposed human body identified through the comparison of antemortem (AM) and postmortem (PM) panoramic radiographs. The AM radiograph was performed for planning dental implants, while the PM radiograph reproduced the same AM technique to enable a reliable comparative procedure. Radiographic dental similarities observed AM and PM led to a positive human identification. The importance of forensic odontology for legal purposes is highlighted and illustrated in the current study.

Oral mark in the application of an individual identification: From ashes to truth.

Forensic odontology is the branch of dentistry which deals with the proper handling, examination, evaluation and presentation of dental findings in the interest of justice. After major disasters and perimortem assaults such as earthquakes, fires, severe head and neck trauma or gross decomposition, accurate and early identification of dead and injured becomes important. In the absence of other records in such cases, identification is based on restorations, missing teeth and prosthetic devices such as partial and complete removable/fixed prosthesis or implant retained devices. This brings out the major role of prosthodontics to investigate the identity of suspects in the criminal cases as well as the deceased human beings in traumatic injuries or in disasters. Denture identification systems are being used as means of postmortem identification of edentulous persons which has evolved from the inclusion of some form of printed label in a denture to more high-tech methods. The provision of implant retained complete lower denture, antemortem, and postmortem radiographs of edentulous persons and correlation of bite marks using special impression techniques provide another potential source of evidence for human identification. Hence, this literature review throws some light on the role played by prosthodontist in forensic odontology.

Potential contribution of periapical radiographic film image processing for forensic identification

ABSTRACT Periapical X-rays are the most common complementary tests in the dental clinic. The indication of image tests in forensic identification depends on the produced X-rays quality. The image processing of conventional radiographs can improve image quality. This study aimed to report the potential contribution of image processing from radiographic films by digitally edited periapical radiographs for case reporting of positive identification. The results of anthropological examinations and dental arches of the victim matched the information transferred by the family of the missing person. The antemortem and postmortem periapical radiographs were digitized on photo scanner (Hewlett-Packard Development Company, HP ScanJet G4050 Photo, United States) and images were processed in Corel PaintShop Pro X4 editing software (Corel Corporation, v14, Canada). The comparison of antemortem and postmortem periapical radiographs digital images allowed to determine 8 concordant points in the contour and delimit the maxillary sinus as well as periodontal and dental structures of the tooth 17. Identification of the individual was possible by digital editing of radiographs in computer software. Editing allowed adjusting image brightness, contrast and sharpness, color temperature and saturation of tooth-jaw structures. Such technological feature effectively contributed to positive identification performed by Forensic Dentistry.

Comparative Evaluation of Potentially Radiolucent Projectile Components by Radiographs and Computed Tomography.

Projectile components that are traditionally radiolucent can be of considerable importance in determination of weapon type and caliber, but they are often missed on evaluation of postmortem radiographs. We hypothesized that these components would be significantly better visualized by evaluation of computed tomography (CT) scans compared to the practice standard of radiography alone. In this project, potentially radiolucent projectile components were both pulled apart and fired, and the radiolucent components were recovered. These components were embedded in blocks of ballistics gelatin and were imaged using both radiography and CT. The scans were evaluated by three blinded, board-certified radiologists for the presence/absence of projectile components and true-negative regions in each block. If a radiologist indicated visualization of a projectile component, they were further requested to describe their observation. It was found that traditionally radiolucent projectile components are not significantly more often identified on CT scans than radiography (p<0.05).

Assessment of Composite Restorations and Their Unique Features in Forensic Identification of Unidentified Human Beings

Background : Dental identification mainly involves the comparison of antemortem and postmortem records. Keiser-Nielson (1980) recommended restored tooth surfaces as the smallest unit to consider in the comparison of dental restorations for identification purposes. Unique appearance of radiographic images of amalgam has led to their application in dental forensic. The present study aimed to investigate the value of composite restorations and their features in forensic identification. Methods: The antemortem sample included 40 periapical radiographs of anterior teeth with class III composite restorations which had been taken at least one year before the study. Ten randomly selected recent radiographs of the same subjects along with two radiographs from other patients were regarded as postmortem samples. Afterward, 12 dentally trained examiners were asked to match the 12 radiographs of group 2 with those of group 1 and to determine which features of the teeth (e.g. shape, contour, and surface) had helped them. Results: Ten examiners were able to correctly match all of the 12 images. According to kappa coefficient, the inter-rater agreement was high (0.8-1.0). The shape of the restoration was the most useful feature in identification. Conclusion: A composite restoration has a unique radiographic morphology that can be used for human identification. Therefore, if the antemortem radiograph of a single composite restoration is available, its comparison with a postmortem radiograph can help identify unidentified human beings.

History of Dental Radiographs in Forensics

Radiography can play an important role in forensic dentistry, mainly to establish identification. This takes the precise form of comparison of ante-mortem and post-mortem radiographs. There are many radiographic views that can be used for identification. This article describes role of dental radiographs in identification.

Os Odontoideum Mimicking Acute Odontoid Peg Fracture

The atlantoaxial complex is a common site for cervical spine injuries, of which fractures of the axis (C2), occur most frequently. Over half of these fractures involve the odontoid process. Numerous developmental anomalies of the axis, although rare, can also occur and may simulate trauma. Specifically, os odontoideum is a cranial-vertebral junction anomaly in which the odontoid remains separate from the body of the axis as an independent ossicle. We report a case of a 53-year-old incarcerated male who was found by his five cellmates hanging partially suspended by a bed sheet. Emergency personnel re-established a pulse for a short time, and the patient was transferred to the hospital. Imaging of the cervical spine pointed to an avulsion fracture of the odontoid process of the axis, raising the possibility of trauma and foul play. Postmortem lateral radiographs revealed a smooth ossicle with a circumferential cortical rim superior to the axis, and a posterior neck dissection failed to reveal evidence of an acute injury. Contrary to the diagnosis of an isolated odontoid fracture, this is a case of os odontoideum. This case emphasizes the importance of a thorough dissection with direct visualization, accompanied by a complete investigation and radiographs. An overview of the development of the axis is discussed, including descriptions of various anomalies of the odontoid that may be encountered during postmortem cervical spine examination. Failure of the forensic pathologist to recognize the developmental anomalies of the axis could lead to improper certification of death, resulting in devastating medicolegal consequences.

Exploding Targets in Recreational Use

Exploding targets are marketed for their ability to indicate long-range marksmanship by detonating upon high velocity impact. The Internet has popularized recreational use of these targets outside of the scope of their intended design. We present a case of a 47-year-old man who was a bystander during recreational use of exploding targets. A .300 Winchester Magnum rifle was used to detonate an exploding target, on top of which was placed a fire extinguisher inside an aluminum pipe. The decedent was struck in the abdomen by a fragment of aluminum and collapsed. Despite emergency efforts at the scene, he was pronounced dead. Scene investigation revealed aluminum fragments throughout the blast radius. External examination and postmortem radiograph showed an entry wound of the left mid-abdomen without evidence of retained shrapnel. The autopsy findings included a hemoperitoneum due to transection of the right common iliac artery and inferior vena cava. A 10.6 g fragment of aluminum was recovered from within the abdomen. This case illustrates a dangerous misuse of exploding targets that has been popularized in the media. It also exemplifies a potential pitfall of a negative radiograph, despite the presence of metal shrapnel, because of the radiolucency of aluminum.

Practical relevance of prescribing superimposition for determining a frontal sinus pattern match

A research that tested the methods suitable for comparing ante- and post-mortem radiographic patterns of frontal sinuses concluded that superimposition should be followed as a stringent method for establishing individual identification. We verified the practical relevance of prescribing superimposition by superimposing ante- and post-mortem frontal sinus patterns recorded in case situations as well as simulated ante- and post-mortem of frontal sinus patterns recorded using archived skulls. For superimposition, the wipe facility available in the vision mixer was employed in addition to the mix mode. Ante- and post-mortem radiographic patterns that were available in two earlier cases were not superimposable. Related simulated ante- and post-mortem radiographic patterns of frontal sinuses are superimposable only when the skull that is initially oriented for recording the ante-mortem radiograph is retained in the same posture for recording the post-mortem radiograph also. Once the skull has been removed from the X-ray table, after recording the simulated ante-mortem radiograph, and repositioned for the simulated post-mortem radiograph, even when the intervening time is 1min, the sinus patterns in these radiographs are not superimposable. Superimposition cannot be used as a conditional requirement for side-by-side comparison of radiographic patterns of frontal sinuses.

Forensic radiology in dentistry.

Radiography can play an important part in forensic odontology, mainly to establish identification. This may take the precise form of comparison between antemortem and postmortem radiographs. Radiographs may also be taken to determine the age of a minor victim and even help in the assessment of the sex and ethnic group. Comparable radiographs are an essential factor to confirm identification in a mass disaster.

Postmortem Analysis of Injuries by Roadkill of a White-eared Opossum (Didelphis Albiventis) by Radiographs and Forensic Necropsy-A Virtopsy Case Report

The white-eared opossum (Didelphis albiventris) is one of the most road-killed animals in Brazil, especially due to its opportunistic habits and great adaptation to urban environment. Although radiology is present in the veterinary daily routine, it is uncommon in forensic necropsies, especially in wild animals. A white-eared opossum killed by a vehicle in a road of the State of Sao Paulo, Brazil was submitted to entire-body radiographs followed by forensic necropsy. The images revealed diffuse increased radio-opacity in both hemi-thoraces possibly of hemorrhagic origin, whereas the forensic necropsy findings were consistent with bloody pleural effusion. It was possible to conclude that postmortem radiographs in wild animals could contribute to determine the cause of death and improve forensic investigations.

İnsan İskeletinden Kimliklendirmede Kemik Protezlerinin Önemi Olgu Sunumu

Bu çalışmamızda; fethi kabir yapılarak elde edilen kemiklerden Radyolojik inceleme yoluyla cesedin iddia edilen kişiye ait olmadığı tespit edilen bir negatif kimliklendirme vakası sunulmaktadır. 2009 yılında ölen bir kadın kasaba mezarlığına defnedilmiş, bunun ertesi günü aynı kasabadan diğer bir kadın hayatını kaybederek aynı mezarlığın başka bir bölgesine defnedilmiştir. Davacıların iddiasına göre; ölen ablasının mezar yerini unutması nedeniyle davalı tarafından annelerine ait mezarın başındaki taş sökülerek hemen yanındaki boş bir mezara dikilmiş, inceleme konusu mezara da davalının ablasının ismi bulunan mermer bir mezar yaptırılmıştır. Davacılar, annelerinin 2006 yılının sonlarında sağ kalçasındaki kırık nedeniyle ameliyat olduğunu ve protez takıldığını belirterek buna ait tıbbi belgeleri mahkemeye delil olarak sunmuşlardır. Fethi kabir yapılarak çıkarılan ceset üzerindeki makroskopik incelemede proteze rastlanmaması üzerine kemiklerin radyografileri de çekilmiştir. Mezardan çıkarılan kemiklerde herhangi bir protez, ortez vida ya da metal cisim olmadığı, her iki femur başının yerinde olduğu saptanmıştır. Dolayısı ile davacıların iddiasının aksine inceleme konusu mezardaki cesedin annelerine ait olmadığı tespit edildiğinden DNA incelemesine gerek görülmemiştir. Sonuç olarak olgumuz, antemortem ve postmortem radyografilerin karşılaştırılmasının kimliklendirmede ne kadar büyük bir değere sahip olabileceğini ortaya koymaktadır. Bu durum, sağlık kuruluşlarında radyolojik görüntü kayıtlarının olabildiğince uzun süreyle ve güvenli bir biçimde saklanması gerektiğini de göstermektedir.Anahtar Kelimeler: Kimliklendirme; Adli Radyoloji; Kemik Protezi; Fethi Kabir

Inca Bone in Human Skulls of the West Anatolian Population

** * SUMMARY: The Inca bones are rarely seen among other inter sutural bones and are accepted as variants of the normal. The incidence of the Inca bones has been rese arched in different populations. The aim of this study was to investigate the rate and types of the Inca bones in West Anatolian population. One hundred fifty-one skulls of West Anatolian subjects of unknown ages and sex were e xamined. None of the specimens showed signs of prior cranial surgery, bony malformation or trauma. The skulls were classified as adults with teeth eruption. The Inca bones were macroscopically determined and analysed. The samples were photoghraphed with Canon 400B (55 mm objective). We follow previous criteria and nomenclatures of the Inca bones. The incidence of Inca bones of examined skulls was 1.98% (3/ 151). We observed 1 incomplete lateral asymmetric, 1 complete undivided and 1 complete asymmetric bipartita Inca bones. Inca os sicles are accessory bones found in human skulls due to ossification failure. Inca bones can be used in personal identification by com paring the ante- and post-mortem radiographs. There are some regional variations in frequencies within each restricted geographical area. In the present study, the incidence of the Inca bones is 1.98% in West Anatolian population. The frequency of the Inca bones in the sk ulls belonging to Hellenistic Roman periods of Cyprus and Constantinople in Natural History Museum of Turkey was 1.59%. The variatio n in Anatolia’s population at different times and regions, because of the migrations, may cause the differences between frequencies in these studies. Evaluation of the presence of the Inca bones may be usefull in identification in forensic medicine and paleodermograph ical studies.

Prenatal diagnosis of metatropic dysplasia: beware of the pseudo-bowing sign

Metatropic dysplasia is a very rare form of osteochondrodysplasia with only one case of prenatal diagnosis described in the literature. It is characterized by marked shortening of the long bones with severe platyspondyly and dumbbell-shape metaphyses. We report a case of metatropic dysplasia that was diagnosed prenatally and describe the findings on US and CT. The pregnancy was terminated and the post-mortem radiographs are shown. The woman had been referred for short and bowed long bones. Severe metaphyseal enlargement was a misleading finding because it had been misinterpreted as limb bowing. Thus when abnormal curvature of the long bones is observed at prenatal US, attention should be drawn not only to the diaphyses but also to the metaphyses because severe metaphyseal enlargement might be responsible for pseudo-bowing.

Triangular geometry-based novel feature and a novel algorithm for human identification using dental radiographs

Dental X-ray has played an important role in identification of missing or unidentified persons. Particularly in cases where other identification clues like fingerprint, iris, etc. are not available and, moreover, dental features remain more or less invariant over time. The purpose of dental image processing is to match the Post-mortem (PM) radiograph with the Antemortem (AM) radiograph based on some unique feature of the radiograph. The first step is to enhance the quality of image and region of interest can be separated. Unique features of a tooth are extracted and identification is performed based on matching of these feature vectors of PM images with those of AM images available in the database. A new feature based on triangular geometry of the tooth has been proposed and thereafter matching of query and database images is performed for identification of the subject. This feature is called the tooth taper parameter.

Positive identification of a burned body using an implanted orthopedic plate

Human identification is usually obtained by comparing fingerprints, antemortem and postmortem radiographs, dental records and also by DNA profiling. Sometimes forensic investigators come across some medical appliances such as orthopedic devices. These medical devices may be useful to achieve positive human identification. This paper aims to present a positive identification of a burned human body by tracking batch numbers engraved in an implanted orthopedic device found in the decedent's left ulna bone. The examiners also collected and analyzed other valuable hints related to the case. Forensic examination can provide reliable positive human identification, even if few, but precise information can be obtained from antemortem and postmortem records. The present report illustrates a set of valuable techniques and how identifying numbers in orthopedic devices are helpful to determine positive human identification in cases of carbonization. As seen in this case, the forensic experts used low-cost identification procedures with accurate results, avoiding DNA profiling method that would be of higher cost and time consuming. Considering social and legal aspects, it is quite important that physicians and dentists understand that correct and accurate records of surgeries they perform, such as fixation of orthopedic devices and dental implants, are utterly relevant and helpful in cases of human identification.

Skull sutures: Changing morphology during preadolescent growth and its implications in forensic identification

Forensic identification of juvenile skulls is a problem area. Although the skull suture patterns have been suggested for use in individualizing human remains by comparing antemortem and postmortem radiographs, the age at which such patterns stabilize and can be useful for identification had been indicated as 7 years. Subsequent researchers have also concurred that antemortem and postmortem radiographs taken after the 7th year would be sufficient to meet the Daubert standard criteria for identifying skulls using radiographs. The suggestions regarding the lower age limit for stabilization of suture patterns have not been verified so far. In this research, the patterns of the sutures in the ectocranial and endocranial surfaces of the lambdoid region in 22 juvenile skulls (age range 1–10 years) and 100 adult skulls (age range 17–70 years) were studied for the relative incidence of different types of suture patterns. The radiographic recordings of the suture patterns in the juvenile skulls were also compared with the patterns seen in the ectocranial and endocranial surfaces. The findings of this study support the proposition that the suture patterns are plastic during the juvenile stage and that they undergo significant remodeling during growth into adulthood. Indicating the possibility of growth related alterations in the sutural morphology, the onset of adulthood is suggested as the age for stabilization of suture patterns in the context of prescribing standards for such criteria as those relating to Daubert.

Forensic radiology at the New York City office of the chief medical examiner (NYC OCME): Current US forensic radiology practices and reflections on the future

Introduction Forensic sciences must adhere to high quality standards in order to present their evidence in court. However, no standards currently exist regarding qualification and certification in Forensic Radiology. At the NYC OCME, medical examiners (ME) decide on a case-by-case basis whether or not post-mortem radiographs should be performed. Radiology technicians take the requested images of either specific areas or the whole body. The ME then interprets the images for use in identification or forensic investigation. There are currently no staff radiologists employed by the NYC OCME. Therefore, if the ME's find images challenging to interpret, they will call in a consultant radiologist for further evaluation. Method This study will retrospectively analyze all cases over the past 5 years to which consultant radiologists have been called. We will gather information on when, how often, and in what types of cases the decision is made to call in a radiology consultant. We will also evaluate what subspecialties within diagnostic radiology were involved and determine if radiologic evidence was given in a court case. Results The expected result is that the use of forensic radiologists is non-standardized within the NYC OCME. There are likely no set criteria for when a radiologist is to be consulted for a case. It is unlikely that radiologists with special training in forensic and post-mortem radiology are consulted. The cases for which the radiologists are most often consulted involve identification of individuals and child abuse. Either an oral or a written report may be submitted. Radiologists may give evidence in court in a small number of cases but most likely the forensic pathologists relay the information. Conclusion Forensic radiology is not standardized as seen in the NYC OCME. Future research should be geared towards establishing when and how Forensic Radiologic assessment should be performed. A drive towards publication of specialty guidelines, credentialing and certification will advance the quality of radiologic assessments in the forensic context.

Identificação humana por meio do estudo de imagens radiográficas odontológicas: relato de caso

INTRODUÇÃO: Dentre os vários documentos que compõem o prontuário odontológico, destacam-se, para fins de identificação humana, os exames por imagem; entre estes, os exames radiográficos, os quais, quando cuidadosamente produzidos e corretamente arquivados, possibilitam a individualização de qualquer pessoa, além de serem de baixo custo. Principalmente por esses motivos, são fundamentais no processo de identificação humana odontológica. OBJETIVO: Fazer a descrição de um caso de identificação de indivíduo carbonizado por meio de análise de radiografias da arcada e demonstrar que a identificação humana odontológica é efetiva e de baixo custo. MATERIAL E MÉTODO: Para a identificação do carbonizado, procedeu-se ao confronto da imagem de radiografia odontológica panorâmica feita anteriormente à fatalidade com as radiografias periapicais realizadas post-mortem. RESULTADO: Foram encontrados 12 pontos de semelhança entre as imagens estudadas, os quais foram suficiente para identificar o cadáver. CONCLUSÃO: O estudo ora em questão possibilitou demonstrar que o método de identificação humana utilizado em Odontologia é efetivo e apresenta baixo custo e boa margem de segurança, visto que trabalha com caracteres altamente individualizadores.