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Forensic Radiology: A Comprehensive Review for Non-Radiologist Physicians and Medical Students

Teaser: 

D'Arcy Little MD CCFP FCFP FRCPC,

D’Arcy Little, MD, CCFP, FCFP, FRCPC, Medical Director, Journal of Current Clinical Care and www.healthplexus.net Radiologist, Orillia Soldiers’ Memorial Hospital, Assistant Professor, Department of Medical Imaging cross-appointed to Department of Family and Community Medicine, University of Toronto, University of Toronto, Toronto, ON.

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Abstract:
Forensic radiology represents the intersection of diagnostic imaging and legal medicine, playing an increasingly vital role in modern medicolegal investigations. This review article provides an overview of forensic radiology for non-radiologist physicians and medical students, covering its historical development, clinical applications, imaging modalities, and medicolegal significance. Key applications include postmortem imaging (virtopsy), identification of deceased individuals, documentation of trauma patterns, detection of non-accidental injury in children, and evaluation of criminal evidence. As imaging technology advances and its integration into forensic pathology increases, understanding the capabilities and limitations of forensic radiology becomes essential for all physicians involved in medicolegal cases. This article aims to provide a foundational knowledge of forensic radiology principles and practices relevant to clinical medicine and legal proceedings.

Key Words: Forensic radiology, postmortem imaging, virtopsy, forensic pathology, medicolegal investigation.
Postmortem CT is the cornerstone of modern forensic radiology, offering rapid whole-body acquisition (5-15 minutes) with excellent skeletal and gas visualization, but the absence of circulation significantly limits soft tissue characterization compared to clinical imaging.
Imaging complements but cannot replace traditional autopsy because it cannot substitute for microscopic tissue examination, toxicology sampling, microbiological cultures, or detection of many disease processes like acute myocardial infarction.
Standardized skeletal surveys are critical for detecting non-accidental injury in children, with classic metaphyseal lesions and posterior rib fractures being highly specific for abuse, and follow-up surveys at 2 weeks increasing diagnostic sensitivity by 27%.
Interpreting postmortem imaging requires specialized expertise to distinguish pathological findings from normal postmortem changes like livor mortis, decomposition gas, and temperature-related density alterations that differ fundamentally from clinical imaging.
PMCT detects more rib fractures than traditional autopsy, particularly posterior and healing fractures obscured by soft tissue, making it superior for documenting thoracic trauma in child abuse cases.
Bilateral skull fractures, fractures crossing suture lines, or complex/depressed fractures in infants suggest inflicted trauma requiring greater force than typical household falls, though absence of skull fracture does not exclude severe head injury.
Three-dimensional CT reconstructions are invaluable for courtroom presentation, allowing judges and juries to understand complex injury patterns, projectile trajectories, and spatial relationships better than 2D images alone.
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Related Terms: Radiology, Forensic radiology, postmortem imaging, virtopsy, forensic pathology, medicolegal investigation
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Introduction to Mindfulness for Physicians

Teaser: 

D'Arcy Little MD CCFP FCFP FRCPC,

D’Arcy Little, MD, CCFP, FCFP, FRCPC, Medical Director, Journal of Current Clinical Care and www.healthplexus.net Radiologist, Orillia Soldiers’ Memorial Hospital, Assistant Professor, Department of Medical Imaging cross-appointed to Department of Family and Community Medicine, University of Toronto, University of Toronto, Toronto, ON.

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Abstract:
This article was modelled after the Mindfulness Research Symposium and Retreat at the University of Toronto* in partnership with monastics from Plum Village, France, January 2026, the monastery of the famous Vietnamese Buddhist monk, Thich Nhat Hanh. (See Figure 1)
Mindfulness, the practice of bringing non-judgmental awareness to the present moment, has emerged as a significant intervention for addressing physician burnout, enhancing clinical decision-making, and improving patient-provider relationships. This article synthesizes teachings from contemplative traditions with contemporary neuroscience to provide physicians with practical, evidence-informed techniques for cultivating present-moment awareness. Drawing on symposium presentations by experienced practitioners, we explore the foundational elements of mindfulness practice, including breath awareness, body scanning, emotional regulation, and the integration of mindful awareness into daily clinical activities. The article emphasizes that mindfulness is not an additional task to be accomplished but rather a quality of attention that can transform routine activities into opportunities for restoration and insight. *https://www.newcollege.utoronto.ca/events/mindfulness-research-symposium/



Key Words: mindfulness, present-moment awareness, physician burnout, decision-making.
1. Mindfulness is non-judgmental awareness of present-moment experience, distinct from relaxation or concentration techniques.
2. The breath serves as an ideal anchor for practice because it is always available, reflects emotional state, and can be attended to discretely.
3. Difficult emotions, when met with acceptance rather than resistance, tend to resolve within 90 seconds; rumination extends suffering.
4. Integration into clinical workflow requires no additional time; it transforms the quality of attention brought to existing activities.
5. Self-compassion is not self-indulgence; it is a prerequisite for sustainable compassionate care of others.
The 90-Second Emotion Rule: Difficult emotions like anger naturally resolve within 90 seconds if you don’t resist them. Suffering extends beyond this only through rumination. Allow the emotion, then consciously choose whether to continue engaging with it.
Transform Transitions into Micro-Resets: Use existing clinical moments—handwashing, walking between rooms, waiting for the EMR—for brief breath awareness. Even a single conscious breath during these transitions helps reset your presence.
Self-Compassion as Professional Responsibility: Self-care isn’t optional; it’s essential for sustainable patient care. When your inner critic says “I’m not good enough,” recognize this as a passing thought, not truth—it’s one aspect of your experience, not your totality.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Radiology, mindfulness, present-moment awareness, Physician burnout, decision-making
Disclaimer: 
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Adverse Childhood Experiences and Chronic Low Back Pain

Teaser: 

Genevieve Belanger, BSc.,1 Khaled Skaik, BSc.,2 Eugene K. Wai, MD, MSc, FRCSC, CIP3

1 Faculty of Medicine, Trinity College of Dublin
2 Faculty of Medicine, McGill University 3Associate Professor, University of Ottawa Division of Orthopaedic Surgery Cross Appointed to School of Epidemiology and Public Health Attending Surgeon, Ottawa Hospital Spinal Surgery Program


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Abstract: While adverse childhood experiences (ACE) is a risk for chronic pain broadly, their specific association with chronic low back pain (cLBP) and recommended management remains unclear. We conducted a systematic review and demonstrated substantial heterogeneity reflecting methodological variability and inconsistent results. However, there was moderate evidence that increasing number of ACE and emotional abuse was associated with cLBP. This suggests a need for an individualized biopsychosocial approach to management with best practice of a trauma informed approach.
Key Words: low back pain, chronic pain, adverse childhood experiences, childhood adversity, systematic review, meta-analysis.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

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Pre-test CME Quiz Post-test CME Quiz
Adverse childhood experiences (ACE) are any preventable act that results in harm, or potential for harm to a child. ACE include but are not limited to, direct acts or witnessing of various forms of abuse, including physical, mental, emotional and sexual
ACE is a risk factor for chronic pain and our systematic review demonstrate moderate evidence that increasing ACE and emotional abuse specifically
A holistic biopsychosocial approach is critical in the management of chronic low back pain CLBP in the setting of ACE
Consider assessing for ACEs in the management of CLBP, especially if there is failure of a biomedical focused approach.
Patients with ACE are at risk for further harm and it is recommended that a trauma informed care approach should be used.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Back Health, low back pain, chronic pain, adverse childhood experiences, childhood adversity, systematic review, meta-analysis