Pediatric Medicine-Postmortem Imaging in Suspected Child Abuse

Postmortem imaging plays an important role in the investigation of cases of suspected fatal child abuse and neglect. Not only can postmortem imaging be used to assess the presence or absence of signs of physical abuse (such as intracranial hemorrhage and certain types of fractures), it can also be a valuable tool for age assessment in neonates/fetuses and to evaluate signs of life in neonates. Postmortem conventional radiography remains the most commonly used and widely available radiological imaging modality following childhood death. Computed tomography should be performed where available, as it is able to achieve higher bone detail, as well as a 3D representation of the body. Magnetic resonance imaging gives excellent diagnostic information about the central nervous system and body organs and is a useful complementary technique to conventional autopsy but is not widely available in a forensic setting. In turn, whichever technique is chosen, it is important that the imaging study is reviewed by someone with expertise in both pediatric imaging as well as postmortem imaging and in collaboration with the clinician, pathologist, and/or anthropologist involved.