An overview of digital X-ray (LODOX StatScan) usage in a South African medico-legal mortuary

X-ray analysis of individuals who have died due to unnatural causes is important for the detection of potential skeletal pathologies, injuries, and foreign objects, which assists in the determination of the cause of death, recovery of evidence, and identification of the deceased. At the Johannesburg Forensic Pathology Services medico-legal mortuary (South Africa), the LODOX Statscan is used due to the system's capability to rapidly produce a full-human-body, high-quality digital image. This study aimed to provide an overview of which cases were selectively x-rayed using the LODOX Statscan at this facility. This was a retrospective mortuary case file review, which highlighted the frequency and reasons for x-ray usage over a four-year period (2016–2019) and described the demographics, circumstances of death and cause of death in x-rayed cases over a two-year period (2018 and 2019). A total of 2026 cases (15.28% of all cases received) were x-rayed over the 2016-2019 period. The purposes for selectively x-raying cases were to assist the autopsy (n=1735), identification (n=228), forensic anthropological analysis (n=34) and research (n=29). the most common circumstance and cause of death in the x-rayed cases was due to gunshot wounds (80% & 85% respectively). This study highlighted the benefits and limitations of low-dosage X-ray digital scans in a facility that is exemplary of many facilities in developing countries where the case numbers are significantly high, manpower is limited, and the lack of funding and infrastructure precludes the use of other modalities commonly used in developed countries, especially were gunshot wound cases are frequent.