Radiological evidence in legal contexts: forensic versus clinical reporting in cases involving living victims of violent crime

Purpose Forensic medical examinations are essential for evaluating victims of potential crimes. Radiology, particularly computed tomography (CT), has become a valuable tool in postmortem and clinical forensic contexts. However, when assessing living victims, forensic evaluations often face challenges due to reliance on clinical records, which primarily focus on medical treatment rather than forensic interpretation. Clinical radiology (CR) reports frequently omit forensically relevant findings. In contrast, forensic radiological (FR) reports may provide more relevant insights into such details, although, this distinction has not been systematically studied. The aim of the study was to evaluate the forensic relevance of CR reports compared to FR reports, with the goal of exploring and understanding potential benefits of involving forensic radiologists in legal investigations. Methods This retrospective study compares CR and FR reports concerning living victims of serious violence in the Netherlands between 2016 and 2022. Cases were included if both report types were available. Three experts reviewed the cases, and a paired samples test was used to assess differences. Results A total of 45 forensic cases were analyzed, including blunt force injuries, stabbings and gunshot wounds. FR reports consistently outperformed CR reports in answering case-relevant forensic questions. In 16 cases with identical FR and CR scores, notable discrepancies were observed, particularly regarding soft tissue findings and skin lesions, which were more comprehensively described in FR reports. Conclusion This study shows that the forensic re-evaluation of clinical imaging in potential crime victims yields more forensically relevant information than the CR reporting.