This project explores the potential of micro-CT scans in the identification of non-accidental paediatric injuries.
Professor Mark Williams
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West Midlands Police, West Midlands Surgical Training Centre.
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The injury pattern in non-accidental injuries in infants is crucial to the overall question of the nature and origin of these injuries. Therefore, maximising the number of detected injuries is essential to an accurate interpretation of events.
The problem is that due to the small size of the injured parts and the subtlety of the injuries, standard skeletal survey or hospital CT scanning might fail to detect all injuries. Micro-CT has the potential to identify these, which can provide suitable guidance for further, more destructive, analyses such as histology.
Using these micro-CT scans to produce visual support for expert testimony in court is an added benefit as images can be helpful to the jury's understanding of medical issues.
Micro-CT scans are conducted in cases of suspected child abuse and examined for evidence of skeletal trauma. The scan images are then provided to the bone specialist to improve their procedure by allowing them to choose the most suitable cutting plane.
Comparison with histology results enables validation of the micro-CT findings. The three-dimensionality of the micro-CT scans has the added advantage of showing injuries that otherwise might not be captured in the histological sections. It further preserves the pre-sectioning state of the sample, thus allowing the identification of sectioning artefacts more easily.
Background research in this area includes determining fracture callus age based on its micro-CT appearance, and establishing baselines of underlying conditions that might influence the actual injury appearance (for example, rickets).
Interim reports or publications
Baier, W., Mangham, C., Warnett, J. M., Payne, M., Painter, M. and Williams, M. A. (2019) Using histology to validate micro-CT findings of trauma in three post-mortem samples- First steps towards method validation. Forensic Science International. 297, pp. 27-34.
Baier, W., Norman, D.G., Donnelly, M., & Williams, M.A. (2021) Micro-CT for the examination of paediatric rib injuries: a case series. Forensic Science International.