The Role of Radiology (X-Ray versus Computed Tomography) in Medicolegal Cases Presented at a Tertiary Care Hospital in Pakistan

  • Rabail Altaf Gambat medical college
  • Abdul Razaque Pir Abdul Qadir Shah Jeelani Institute of Medical Science
  • Mohsin Hussain Pir Abdul Qadir Shah Jeelani Institute of Medical Science
  • Asghar Ali Memon Gambat medical college
  • Imran khan Memon Ghulam Muhammad Mahar Medical College
  • Nargis Pirya Gambat medical college
  • Abdur Rehman Usman Memorial Hospital
  • kiran Abbas Jinnah Postgraduate Medical College
Keywords: Computed Tomography, Forensic Medicine, Head Injury


Objectives:  A prospective observational study was aimed to assess the role of plain radiographs and computed tomography in detecting head injuries presented at the medicolegal office at the Forensics and Radiology Departments, Gambat Medical Hospital, Sindh.

Material and Methods:  All cases referred from the Medicolegal Office (MLO) with head injury were included. All victims underwent X-ray head and computed tomography skull was done with 1 or 1.5 cm thick axial sections without administration of intravenous contrast. The radiological reports of X-ray head and CT scans were documented and comparatively evaluated.

Results:  Mean age was 38.63 ± 3.91 years. In 51 (45.13%) cases, X-ray was able to detect skull fracture, while CT scan detected 64(56.64%) skull fractures. There were 54 (84.3%) true positives, 3 (2.6%) false positives, 10(8.8%) false negatives, and 40 (40.7%) true negatives. The accuracy of X-ray to detect skull fracture was 88.50%.

Conclusion:  X-ray had a sensitivity and specificity of 84.38% and 93.88%, respectively. It is a reliable tool to detect skull fractures in victims of assault in comparison with CT scans. X-ray is also associated with low dose radiation exposure as compared with CT scan which delivers 70 times more exposure than the former.


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