Karol Karnecki, Adrian Wrocławski, Michał Kaliszan, Tomasz Gos
{"title":"Fatal gunshots in the Tri-City metropolitan area, Poland between 1998 and 2021.","authors":"Karol Karnecki, Adrian Wrocławski, Michał Kaliszan, Tomasz Gos","doi":"10.1007/s00414-025-03459-5","DOIUrl":"https://doi.org/10.1007/s00414-025-03459-5","url":null,"abstract":"<p><p>This study analyzes 92 firearm fatalities, including 54 suicides and 26 homicides, in the Tri-City area, Poland between 1998 and 2021. The firearm-related death rate was 0.44 per 100,000 residents, which is more than double the published rate for Poland (0.20). During the period under examination, there was an upward trend in the number of suicides and a decline in the number of homicides. In addition, the decrease in gun homicides was associated with rising GDP per capita over the study period, along with other noteworthy-but not statistically significant-interactions between homicides, suicides, and various economic or gun-related factors. Most victims were males (90.2%), who were older on average than the female victims. In 66 cases, there was a single gunshot wound, which was more common in suicides (92.6%) than in homicides (33.3%). The remaining cases, which included 4 suicides and 16 homicides, involved multiple gunshot wounds. In suicides, gunshot wounds to the head were predominant (77.8%) and most often to the right temporal region or mouth. Gunshot wounds to the head were less common in homicides (37.5%) than in suicides but most often located at the left temporal region, the back of the head, or the face. A higher proportion of gunshot wounds to the chest was observed in homicides (34.7%). Short-barreled firearms, most often a semi-automatic pistol, predominated in the analyzed material.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Forensic insights into primary pyomyositis: autopsy and post-mortem CT scan based-analysis.","authors":"Chun-Ting Chiang, Yumi Hoshioka, Yohsuke Makino, Maiko Yoshida, Ayumi Motomura, Fumiko Chiba, Suguru Torimitsu, Rutsuko Yamaguchi, Daisuke Yajima, Go Inokuchi, Shigeki Tsuneya, Hirotaro Iwase","doi":"10.1007/s00414-025-03460-y","DOIUrl":"https://doi.org/10.1007/s00414-025-03460-y","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the findings of pyomyositis by computed tomography (CT) imaging at autopsy to establish the correct diagnostic approach for this disease in the postmortem setting.</p><p><strong>Materials and methods: </strong>A total of 6,964 autopsy cases with CT imaging from two forensic center databases were examined to identify primary pyomyositis. Basic demographics, external findings, postmortem CT findings, and autopsy results were reviewed.</p><p><strong>Results: </strong>Ten cases of primary pyomyositis were identified. All of the deceased individuals were older than 40 years of age without definitive evidence of human immunodeficiency virus infection. Five individuals had a history of trauma, with one case of trauma occurring more than 1 year previously. Pyomyositis was mostly located in the extremities. Three individuals showed pyomyositis in more than one muscle group. Only one individual showed signs of infection before the autopsy. Three individuals had grossly identifiable erythema. Nine individuals showed positive imaging findings, such as swelling, fat stranding, decreased density, fluid collection, and gas formation, on a CT scan. One individual had no findings of pyomyositis and this was discovered incidentally.</p><p><strong>Conclusion: </strong>This study shows differences from previous clinical case series of pyomyositis, such as the absence of young age groups and human immunodeficiency virus/acquired immunodeficiency syndrome cases, and a unique case of pyomyositis that occurred more than 1 year after a traumatic incident. Grossly identifiable erythema is rare, posing a considerable diagnostic challenge. However, CT imaging is useful in detecting infection.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cristiana Palmela Pereira, Raquel Carvalho, Diana Augusto, Tomás Almeida, Alexandre P Francisco, Francisco Salvado E Silva, Rui Santos
{"title":"Development of artificial intelligence-based algorithms for the process of human identification through dental evidence.","authors":"Cristiana Palmela Pereira, Raquel Carvalho, Diana Augusto, Tomás Almeida, Alexandre P Francisco, Francisco Salvado E Silva, Rui Santos","doi":"10.1007/s00414-025-03453-x","DOIUrl":"https://doi.org/10.1007/s00414-025-03453-x","url":null,"abstract":"<p><strong>Introduction: </strong>Forensic Odontology plays a crucial role in medicolegal identification by comparing dental evidence in antemortem (AM) and postmortem (PM) dental records, including orthopantomograms (OPGs). Due to the complexity and time-consuming nature of this process, imaging analysis optimization is an urgent matter. Convolutional neural networks (CNN) are promising artificial intelligence (AI) structures in Forensic Odontology for their efficiency and detail in image analysis, making them a valuable tool in medicolegal identification. Therefore, this study focused on the development of a CNN algorithm capable of comparing AM and PM dental evidence in OPGs for the medicolegal identification of unknown cadavers.</p><p><strong>Materials and methods: </strong>The present study included a total sample of 1235 OPGs from 1050 patients from the Stomatology Department of Unidade Local de Saúde Santa Maria, aged 16 to 30 years. Two algorithms were developed, one for age classification and another for positive identification, based on the pre-trained model VGG16, and performance was evaluated through predictive metrics and heatmaps.</p><p><strong>Results: </strong>Both developed models achieved a final accuracy of 85%, reflecting high overall performance. The age classification model performed better at classifying OPGs from individuals aged between 16 and 23 years, while the positive identification model was significantly better at identifying pairs of OPGs from different individuals.</p><p><strong>Conclusions: </strong>The developed AI model is useful in the medicolegal identification of unknown cadavers, with advantage in mass disaster victim identification context, by comparing AM and PM dental evidence in OPGs of individuals aged 16 to 30 years.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing trace DNA recovery from disposable face masks: insights from the COVID-19 era and beyond.","authors":"Salem K Alketbi, Will Goodwin","doi":"10.1007/s00414-025-03435-z","DOIUrl":"https://doi.org/10.1007/s00414-025-03435-z","url":null,"abstract":"<p><p>Trace DNA plays a pivotal role in forensic investigations, serving as a critical tool for linking suspects to criminal activities. During the COVID-19 pandemic, disposable face masks emerged as key items of forensic interest, particularly in cases where suspects used them to conceal their identities. This study evaluates the efficiency of two trace DNA collection methodologies-cotton swabbing and tapelifting-for recovering DNA from face masks. Samples were collected from 50 masks worn by suspects in robbery cases, utilizing the Copan cotton swab (150 C) and the SceneSafe Fast™ minitape (K545). Statistical analysis revealed that minitapes (MT) significantly outperformed cotton swabs (CS), yielding higher DNA concentrations (mean MT: 0.41 ng/µL, CS: 0.17 ng/µL; p < 0.05) and recovering more complete DNA profiles, including full single (FS) and full mixed (FM) profiles (p < 0.05). These findings highlight the superior efficiency of MT, particularly for recovering trace DNA from small or fabric-like surfaces. The study underscores the importance of selecting optimal collection methods in forensic investigations, especially for modern evidence types such as face masks. Recommendations include the routine adoption of minitapes in casework involving face masks and further research into their efficacy on other mask types and under varied environmental conditions. This research offers valuable insights to refine trace DNA recovery strategies, enhancing the reliability of forensic evidence.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Palamenghi, Antonio Aragon-Molina, Giulia Caccia, Debora Mazzarelli, Sofia Alemanno, Ruggero Donida Labati, Fabio Scotti, Vincenzo Piuri, Carlo Pietro Campobasso, Cristina Cattaneo, Danilo De Angelis, Daniele Gibelli
{"title":"From traditional to innovative: implications of cranial non-metric traits in personal identification.","authors":"Andrea Palamenghi, Antonio Aragon-Molina, Giulia Caccia, Debora Mazzarelli, Sofia Alemanno, Ruggero Donida Labati, Fabio Scotti, Vincenzo Piuri, Carlo Pietro Campobasso, Cristina Cattaneo, Danilo De Angelis, Daniele Gibelli","doi":"10.1007/s00414-025-03462-w","DOIUrl":"https://doi.org/10.1007/s00414-025-03462-w","url":null,"abstract":"<p><p>In forensic anthropology, personal identification is mainly performed through a qualitative assessment and comparison of morphological bone and dental features between antemortem and postmortem data. Although non-metric traits have been traditionally considered as individualizing features, their potential has been limitedly investigated. Indeed, frequencies of variants can represent an additional tool to provide probabilities and likelihood ratios that an individual presents a combination of traits, hence quantifying a possible identification. This study investigates the potential of cranial non-metric traits as individualizing features in personal identification, and it describes the application of this probabilistic approach to a sample from a mass fatality which occurred in 2015. 119 crania of males were assessed for scoring 35 non-metric traits by presence and absence. For each cranium, the compound frequencies of independent traits, probabilities and likelihood ratios that a cranium presents a specific blend of traits were calculated. Over 70% of the likelihood ratios exceeded 1,000,000, providing extremely strong evidence that a specific set of traits corresponds to a cranium. Probabilities to find an individual with the set of traits within a group of 528 people (corresponding to the recovered bodies for this case) were extremely low (e.g., 0.006 people out of 528). The considerably high likelihood ratios and low probabilities suggest that combinations of cranial non-metric traits are extremely specific to the single individual, hence they represent valuable individualizing features. Despite this approach does not seem immediately applicable for the resolution of this case because of the dearth of appropriate antemortem images, collecting cranial non-metric frequencies may be worth of further investigation as a supplementary tool to screen potential identities and provide quantitative evidence to the investigators and the judge.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yasmeen M Taalab, Dorothea Kaufmann, Aysche Landmann, Emily Marie Ungermann, Sarah Heinze, Barbara Stöttner, Anastasia Tsaklakidis, Andreas Schroff, Florian Konrad, Alexander Mezger, Sophia Schlenzig, Robert Yen, Kathrin Yen
{"title":"Improving forensic healthcare: ARMED, a new telemedical examination.","authors":"Yasmeen M Taalab, Dorothea Kaufmann, Aysche Landmann, Emily Marie Ungermann, Sarah Heinze, Barbara Stöttner, Anastasia Tsaklakidis, Andreas Schroff, Florian Konrad, Alexander Mezger, Sophia Schlenzig, Robert Yen, Kathrin Yen","doi":"10.1007/s00414-025-03463-9","DOIUrl":"https://doi.org/10.1007/s00414-025-03463-9","url":null,"abstract":"<p><strong>Background: </strong>the Istanbul Convention demands care to victims of violence while upholding forensic standards. Victims, however, often seek medical help at hospitals where the availability of forensic experts is limited. This results in overlooked injuries and lost or damaged evidence, ultimately impacting court proceedings and identification of individuals at risk. The aim of this paper was to establish real-time remote guidance for distant physicians during the forensic examination of violence victims.</p><p><strong>Methods: </strong>Augmented Reality Assisted Medical Evidence Collection and Documentation (ARMED) was established in Heidelberg at the Institute for Forensic and Traffic Medicine (IFTM) in 2023 as an innovative telementoring model. Video-teleconferencing components including a head-mounted device (HMD), a customized software package, hardware devices, and a data management portal were employed to facilitate seamless expert care delivery, data sharing, and to ensure privacy and confidentiality. ARMED platform was evaluated in three partner hospitals with parameters including internet connection stability, clarity of live-streaming and audio-visual communication, the quality of photos, and the safety of data management.</p><p><strong>Results: </strong>The combination of RealWear Navigator 500 as HMD, a customized version of videoconferencing software, and a portal server system for safe and secure patient data management constituted a robust, user-friendly, and practical telemedicine solution.</p><p><strong>Conclusion: </strong>ARMED facilitates real-time communication between healthcare providers and forensic experts, enhancing their ability to recognize and detect injuries effectively. This holds the potential to significantly improve the process of evidence collection for documenting cases of violence, ultimately aiding in the pursuit of justice and the protection of victims.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nadeem Mubarik, Masroor Ahmad Ganei, Shivani Dixit, R K Kumawat, Jaison Jeevan Sequeira, Naseer Ahmad Ahangar, Shahul Ahmad Kanth, Imtiyaz Ahmad Dar, Ishrat Mushtaq, Mohammad Mohsin, Mohammed S Mustak, Gyaneshwer Chaubey, Sania Hamid, Pankaj Shrivastava
{"title":"Exploring the genetic implications of demographic dynamics in Jammu and Kashmir using autosomal STRs.","authors":"Nadeem Mubarik, Masroor Ahmad Ganei, Shivani Dixit, R K Kumawat, Jaison Jeevan Sequeira, Naseer Ahmad Ahangar, Shahul Ahmad Kanth, Imtiyaz Ahmad Dar, Ishrat Mushtaq, Mohammad Mohsin, Mohammed S Mustak, Gyaneshwer Chaubey, Sania Hamid, Pankaj Shrivastava","doi":"10.1007/s00414-024-03364-3","DOIUrl":"10.1007/s00414-024-03364-3","url":null,"abstract":"<p><p>The Union Territory of Jammu and Kashmir has always been a point of contention among India, Pakistan, and China for various reasons. This region has great significance historically due to its geography and ethnic diversity. However, a comprehensive genetic study providing the genetic landscape of Jammu and Kashmir was lacking until now. In this study, we analysed 21 hyper-variable autosomal STR loci of 694 individuals from Jammu and Kashmir and compared them with neighbouring populations to explore the genetic implications of demographic dynamics that have taken place in this region. Our findings suggest that the population of Jammu and Kashmir is a genetic mixture of two major clines, northern and southern, that correspond with the variation in geography, linguistics, and demography of the region. Broadly, the gene flow into the southern cline appears to be in historical times perhaps as a result of the spread of Gurjars, Dogri language and invasions of Mongols. However, the arrival of ancient nomadic tribes into this region may belong to the time depth of the arrival of pastoralist communities in this region. As a future perspective, a comprehensive study including samples from individual tribes will provide fine-scale structure of the gene pool of Jammu and Kashmir.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"563-570"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ioannis Ketsekioulafis, Konstantinos Katsos, Christoforos Kolentinis, Dimitrios Kouzos, Konstantinos Moraitis, Chara Spiliopoulou, Emmanouil I Sakelliadis
{"title":"Humanitarian forensic medicine: a systematic review.","authors":"Ioannis Ketsekioulafis, Konstantinos Katsos, Christoforos Kolentinis, Dimitrios Kouzos, Konstantinos Moraitis, Chara Spiliopoulou, Emmanouil I Sakelliadis","doi":"10.1007/s00414-024-03381-2","DOIUrl":"10.1007/s00414-024-03381-2","url":null,"abstract":"<p><p>Various concerns relating to international humanitarian law and human rights were risen by natural catastrophes (tsunamis, floods, fires), the Covid-19 pandemic, the epidemic breakouts of Ebola, as well as the significant migrant wave observed in the Mediterranean region. Forensic Medicine has direct interactions with both domestic and international law, and thus is frequently asked to provide solutions for these issues. The term \"Humanitarian Forensic Action\" (HFA), which refers to the application of forensic science to serve humanitarian endeavors, was created. The management of crises including armed conflicts, natural disasters, and humanitarian crises is therefore related to HFA. HFA is a specialized field of forensic sciences that is used to handle the identification of the deceased and human remains, as well as to contribute to the management of the dead, the management of mass disasters, and the investigation of abuse and torture. The psychosocial effects that these tragic events have on the victims, their loved ones, and society at large represent another HFA-related field. Firstly this systematic review aims to present all available international literature that discusses HFA as a unique forensic discipline. Secondly, through this review, it is hoped that HFA awareness will be risen among forensic practitioners, thus allowing improved adoption in general and future development as a branch of forensic sciences. As far as we are aware, there isn't another systematic study that presents the entirety of HFA's branches at once.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"747-761"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edmilson Ozorio Dos Santos, Andrey Wellington Moscardini, Ivan Dieb Miziara
{"title":"A comprehensive epidemiological assessment of female rape in São Paulo State, Brazil: trends, patterns, and implications for public health.","authors":"Edmilson Ozorio Dos Santos, Andrey Wellington Moscardini, Ivan Dieb Miziara","doi":"10.1007/s00414-024-03354-5","DOIUrl":"10.1007/s00414-024-03354-5","url":null,"abstract":"<p><p>Sexual violence against women remains a global challenge, with Brazil exemplifying persistent issues despite legislative advancements. This study examined sexual violence within São Paulo state, Brazil's largest and economically affluent state, focusing on prevalence, patterns, forensic evidence, and health consequences. We analyzed 40,757 medical reports of alleged cases of rape against women available from the São Paulo Medical Legal Institute from 2014 to 2017. An increase in female rape cases was observed, reflecting broader societal trends, but underreporting, prevalent due to fear and stigma, underscored the need for multifaceted interventions. We also explored correlations between rape prevalence and the Human Development Index, highlighting disparities between urban and rural areas. Additionally, the study revealed concerning proportions of cases involving vulnerable victims, emphasizing the imperative for tailored interventions and legislative reforms. Furthermore, we demonstrated that only a small portion of medicolegal examinations were able to find evidence of sexual violence or recent sexual acts, necessary for conducting the criminal investigation of the alleged act. Therefore, despite challenges in forensic evidence collection, efforts to enhance medical examination protocols and awareness among professionals are crucial. Moreover, findings underscored the significant health consequences of rape, including unwanted pregnancies and sexually transmitted infections, necessitating comprehensive healthcare services for survivors. In conclusion, we reinforced that addressing sexual violence demands coordinated action, including legislative reforms, community engagement, and survivor-centered approaches, to create safer and more resilient communities.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"763-777"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Identification of gunshot entry wounds using hyperdense rim sign on post-mortem computed tomography.","authors":"Emilien Jupin-Delevaux, Corentin Provost, Ghazi Hmeydia, Marie-Edith Richard, Lilia Hamza, Tania Delabarde, Marie Crahès, Validire Pierre, Bertrand Ludes, Catherine Oppenheim, Joseph Benzakoun","doi":"10.1007/s00414-024-03362-5","DOIUrl":"10.1007/s00414-024-03362-5","url":null,"abstract":"<p><p>Post-mortem computed tomography (PMCT) is an increasingly utilized tool in forensic medicine for evaluating head gunshot injuries. Vault bevelling sign, when present, provides information regarding entry and exit wounds; when absent, identifying wound type on PMCT remains challenging. A cutaneous hyperdense ring, described in an animal study by Junno et al. (2022), may be indicative of contact shots. We hypothesized that it could also be observed in human gunshot injuries. Our study evaluates the reliability of the cutaneous hyperdense rim sign for identifying entry gunshot wounds in PMCT. After excluding complex and mucosal wounds, two operators retrospectively evaluated 64 gunshot wounds (30 entry and 34 exit wounds) in 34 head PMCT cases (2018-2022). Gold standard for wound type determination was the autopsy report. The hyperdense rim sign was defined as at least two-thirds of a continuous cutaneous hyperdense circle on a multiplanar reconstruction of cutaneous tissue tangent to the wound. The hyperdense rim sign demonstrated a specificity of 97% (95% CI: 85-100%) and a sensitivity of 63% (95% CI: 44-80%) for identifying entry wounds. Moreover, in 16 external examination reports where the presence of powder residues or bullet wipe at entry wound was explicitly mentioned, a positive association was observed between hyperdense rim sign and the presence of these elements (p = 0.018). These findings suggest that the hyperdense rim sign, when present, may be a valuable tool for entry wound determination in gunshot injuries, interpreted in conjunction with other CT and autopsy features.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"619-626"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}