The importance of medical imaging history for medicolegal evaluation

As with all traumatic pathologies, determining when a fracture occurred and during which event it occurred is necessary for an accurate medicolegal evaluation. Among the 4,224 cases for which forensic reports were prepared, the report outcome changed in 105 cases (2.5%) when prior medical imaging was included in the medicolegal evaluation. In the initial assessment of the cases (based on emergency department medical records and radiology reports), a bone fracture was recorded in 59.0% of the cases, no bone fracture in 10.5%, and a suspected bone fracture in 30.5%. In the final evaluation-conducted by the forensic medicine outpatient clinic-where current medical images were compared with prior medical images, it was determined that a bone fracture had occurred in the most recent trauma in 17.1% of the cases, that no new fracture attributable to the most recent trauma was present in 79.1%, and that new fractures in addition to old bone fractures were present in 3.8%. We believe that, when analysing current medical images, the search for prior medical imaging and the comparative analysis of obtained prior images with current images should be a routine component of medicolegal evaluation for all forensic cases, regardless of case type.