Application of qisas and diyat act's terms for reporting in current forensic radiology practice

To determine the practical use of the application of Qisas and Diyat Act's terms for medicolegal x-ray reporting in the context of present local forensic radiology practice.

A cross-sectional study. Place and Duration of the Study: Radiology Department, Dow University of Health Sciences (DUHS) and Civil Hospital, Karachi (CHK), from January to December 2004.

The study included all cases referred to radiology department, DUHS and CHK for medicolegal X-ray reporting during the study period where a skeletal injury was suspected. Those X-rays conducted outside Karachi, burns-injury cases, pregnant ladies' cases and technically faulty X-rays were excluded. The studied variables were the demographic characteristics of each case, the mode of injury as alleged, the region and the extent of injury as visible on these x-rays; and the ancillary imaging techniques done to further evaluate the injury. Each injury was reported as per Qisas and Diyat Act 1990's terms and confirmed with medicolegal officer's final report. The frequency distribution, percentages and means were determined for each variable.

There were 281/1972 (0.42%) cases of radiographically visible skeletal injury. Those with major degree of trauma (fracture-displaced or otherwise), the injury could be explicitly termed as required by the said ordinance, Jurh Jaifah (fractured ribs), "Jurh Ghair Jaifa Munaqillah' and Hashimah' (peripheral fracture), and 'Shajjah Hashimah' (head and face fractures). 'Shajah Damighah' and 'Ammah' (fractures meninges with intracranial hematoma) could only be diagnosed with CT. 'Jurh-Ghair Jaifah Mudiah' could only be decided by combining physical examination with MRI in two cases-plain x-rays being unhelpful. Radionuclide scan was not called for in a single case.

The presently recommended legal terminology for fracture reporting and sub classification is comprehensive, however, reporting the trauma short of fracturing the bone, requires the use of advanced imaging techniques such as the CT scan and the MRI. In the absence of these techniques, the application of the present terms depends mainly on the examination findings of the first examining medical officer rather than radiological evidence such as X-rays. So forensic radiology referrals should utilize CT scan, MRI in skeletal trauma.