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Radiography is a term used to describe a variety of techniques used to visualize the internal body using x-ray techniques (FDA, Radiography). These techniques include, but are not limited to, x-rays, computed tomography (CT) scans, and fluoroscopies. These techniques are used to create and record static imagery of the internal body for medical and identification purposes. I will be focusing solely on x-rays and how they can aid in reaching a positive identification of an unknown body post mortem. To begin, I will give some history of x-rays and how they were created and used. Then, I will discuss information within an x-ray that could be used to make a positive identification. Finally, I will provide examples of cases that resulted in a positive identification due to x-ray comparison.
Wilhelm Roentgen of Wuerzburg University in Germany discovered a new kind of ray, subsequently named the x-ray, in 1895 (History of Radiography, Nov. 14). He made his discovery inadvertently while working with a cathode-ray tube in his lab. Roentgen soon discovered that that this new type of ray could pass through things such as paper and skin, but not bone or metal. The first x-ray ever performed was actually on a box full of weights so that Roentgen could show his friends (History of Radiography, Nov. 14). Another of his early x-rays was of his wife’s hand, shown below
Within months of Roentgen’s discovery, medical institutions around the world had created radiographs for medical purposes; many used them to assist in surgeries (History of Radiography, Nov 14). Not long after hospital use began, x-rays began to be used on the battlefield to find the location of bullets and shrapnel in wounded soldiers.
It did not take long for people to realize that radiographs could be used for identification purposes. By 1896, it was suggested by Bordas that x-rays could be utilized “…for identification through the visualization of old fractures, bullets, or other known peculiarities…” (qtd. In Thompson, Upton and Black 221). Furthermore, it was found that x-rays provided a better way to measure the bones than the anthropological classification system at the time. Anthropological classification was a system developed by Alphonse Bertillion that measured five areas of the body that remained constant in the adult skeleton. This system, now enhanced by x-rays, was used as a means of identification, whether ante mortem or post mortem, in conjunction with fingerprints. To make an identification post mortem, before x-rays, was far from an exact science. Rather than measure a deceased body and then compare these measurements with records, they could now measure an image of the skeleton, which yielded more accurate results. This method was only useful if the decedent was known and had anthropological measurements on record. The first incident of positive identification of human remains by radiography was in 1927 by Culbert and Law (Thompson, Upton, and Black 222). They compared ante mortem and post mortem x-rays of the frontal air sinuses to make a positive identification of an unknown body.
Radiographs can be of use on most any case where identification is needed, whether the remains are skeletonized or not. As long as there are accurate, well-kept ante mortem records, otherwise they may be of no use to investigators. For instance, I just found out that the radiographs from my childhood accident have been destroyed because of their age; if they were ever needed to assist in identifying me, they would be of no use now. This is an issue that investigators make come across when trying to access older radiographs or when dealing with older remains. Although radiographs can be used in most cases, they are especially helpful when the traditional methods of DNA and fingerprints are not possible because the lack of soft tissues. For instance, in cases where the remains have decomposed, skeletonized, fragmented, or burned radiography comparison may be the only way to make a positive identification.
In order for radiographic comparison to be of use during an investigation into the identification of human remains they first must have a clue as to who the individual may be. These clues could be, but are not limited to, gender, ethnicity, or age of the remains that could be provided by a missing persons report. Even then, in order for radiographs to be of forensic value, two requirements must be met: the morphological feature being compared must be unique to the individual and the feature must remain stable over time (Kahana, 8). This is where accurate ante mortem record keeping by medical professionals is of great importance; without proper ante mortem radiographs to compare post mortem radiographs, identification could be impossible.
One area on an x-ray to focus on for identification purposes is the cranial region. The cranial region can show areas of past trauma or surgical intervention. But, the most important features that can be seen in this region are facial structures. These include the most common bone markers compared for identification purposes, which are frontal sinuses, anatomic anomalies, and dental restorations (Kahana, 8). Sinus comparison has proved to be a very accurate identification tool. In a study by Kullman et al, researchers matched 99 pairs of cranial radiographs by comparing frontal sinuses (Kullman et al, 7). Another useful area for comparison and identification in the cranial region is the mouth. Teeth are the strongest part of the human body and therefore the most resistant to destruction. Combine that with the countless number of combinations of dental artifacts such as crowns, bridges and fillings, and missing teeth, and the differences in root growth of the teeth, you have great way to identify remains. This method is so effect that the Israeli Defense Forces began mandatory dental radiographs as a part of their enrollment procedure to create a better identification database for their soldiers (Kahana, 9).
Postcranial radiographs can be extremely useful as well; postcranial refers to all parts of the skeleton from the neck down, it does not include the cranium. Postcranial features that can be helpful in identification include morphology of the vertebrae, signs of degenerative processes, evidence of new or healed trauma, medical artifacts or signs of medical intervention (Kahana, 9). Any of the previously stated features can serve as individualizing markers and create a positive identification when matched by comparing post and ante mortem records. Medical artifacts may even yield serial numbers, which can be matched to a specific patient and further cement the identification.
Radiographic identification is most useful when there is a mass disaster that results in the loss of soft tissues, dismemberment, mutilation, or incineration. It is at this time that no other method of identification could be possible that radiographic comparison is most useful. In many scenarios investigators may never find an entire body to identify; they may only find an arm, leg, or even just a finger. But, even with so little of the body left identification could still possibly be made which speaks to the importance of radiography. Kahana analyzed ten mass disasters that forensic odontologists were used to identify remains and they averaged only a 55% success rate (Kahana, 9). In another instance they only had a 6.24% success rate. In these disasters forensic radiologists and postcranial images would be extremely important in potentially identifying the other 45% and 94% respectively.
A great example of when radiographs assisted in the identification of otherwise unidentifiable remains is when a body was found floating in the Colorado River. The body, missing its head and hands, was anthropologically profiled and estimated to be that of a 20-30 year old male, medium build and five feet nine inches tall. They also deduced that he had been stabbed 57 times in the chest and shot with a shotgun. The profile led them to a possible match with a missing persons report. The comparison of ante and post mortem x-rays show multiple similarities. A radiograph of the right wrist showed two radiopaque areas, not allowing the passage of x-ray through, on the distal end of the radius (Khana, 10). These same radiopaque areas were found on the post mortem radiographs of the victim. Combining the anthropological similarities and the radiological findings, the victim was positively identified.
Another instance where positive identification was the result of forensic radiography occurred in Ireland in 1988. An incinerated car was found in a rural area with exceptionally burned body is the driver seat. It was revealed that the car had been rented to an off duty police officer in 1987 and subsequently the officer was reported missing the very next day. The identity of the body could not be confirmed through traditional methods of fingerprints or DNA due to the age of the remains and extensive damage to the remains. However, three cranial radiographs were available of the suspected victim. The lateral view of the cranium provided the most anatomical features for comparison. Some of the features that could be viewed for comparison on both ante and post mortem radiographs are: shape of the maxillary sinuses, roots, crowns and internal anatomy of the upper right molars, and the shape of the occipital bone. When the radiological similarities were combined with the investigatory data, there was enough evidence for a positive identification (Jablonski and Shum, 223-224).
The third instance of forensic radiology leading to an identification of otherwise unidentifiable human remains occurred in Ireland in March of 1988. A human torso was discovered floating in the ocean. An autopsy determined the torso belonged to a young female and that time of death was within one week of its discovery. The height of the female was determined to be between five feet 2 inches and five feet six inches by means of measuring the femur. The appearance of the pubic symphysis determined that the female was approximately between 25 and 33 years old. The information provided by the autopsy of the torso was compared to a list of missing persons. Of the four possible matches, one had a radiograph of her abdomen available. When this ante mortem radiograph was compared to a post mortem radiograph taken prior to autopsy, there were multiple points of similarity. Some of the similarities that were found were: scoliosis of the lumbar spine, missing the twelfth rib, and the shape of the iliac crests. These unusual and exact features, supplemented by a known birthmark found on the torso as well, led to the positive identification of the individual from the missing persons report (Jablonski and Shum, 226-227).
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