Radiological indicators to serve the purpose of juvenile justice system ordinance, 2000

OBJECTIVES: To document radiological age indicator for differentiating Juvenile from adult offender for the purpose of Juvenile Justice System Ordinance, 2000 of Pakistan

STUDY DESIGN: Perspective descriptive study

SETTING: Department of Radiology and Imaging, Liaquat University Hospital Jamshoro/ Hyderabad, Sindh, Pakistan

STUDY PERIOD: June 2007 to December 2008

METHOD: Radiological study of adolescents both males and females [Total 394 comprising of 145 females and 249 males] subjects studying in various academic institutions of Hyderabad, representing the heterogeneous population was conducted with an object to observe the union of various bones that can provide an age indicator of 18 years for both genders

RESULTS: X - Ray pelvis showing fusion of iliac crest with the rest of the bone and X- Ray medial end of clavicle showing appearance, represents age 18 years + 2 months in females, whereas in males X- Ray shoulder joint showing complete Epiphyso- Diphyseal union and their X- Ray pelvis still showing no fusion of iliac crest, represents same age group of 18 years+ 2 months

Radiologically female subjects are one year ahead of their counterparts, so for the skeletal maturity findings are concerned

CONCLUSION: This study concludes that for females, if appropriate radiographs [X- ray pelvis and X- ray chest] showing fusion of iliac crest and appearance of epiphysis at medial end of clavicle the age is 18 years. In male population when radiograph of proximal end of humerus bone gives impression of union, it is concluded that the person has attained the age of 18 years

Radiological indicators for determination of age of consent and criminal responsibility

Objectives: to establish radiological markers, by ossification form of appearances and fusion for determination of Medico legal important ages for consent and criminal responsibility, for our population

Study design: perspective observational study

Setting: Department of Radiology and Imaging, Liaquat University Hospital Jamshoro / Hyderabad Sindh

Study period: June 2006 to December 2008

Method: Total 1381 Subjects comprising of 617 female and 764 male, free from any musculoskeletal, nutritional and endocrinal disorder and confirmed dates of births were selected, representing the population of Hyderabad city and adjoining areas. The Subjects were divided into 9 groups on the basis of their age and purpose of study. Radiographs of wrist, elbow, shoulder and hip were taken in accordance to the age group and anticipated findings and radiological changes were observed and recorded

Results: Radiograph of wrist showing ossification of trapezoid at the age of 7 years and pisiform at 12 years in both sexes in 100% of cases proved to be a good indicator of the required age groups. fusion of Epiphysis distal Radius and ulna, proximal Hummers and iliuc crest can be relied upon as age indicator in Females and Males from 16 to 18 years

Conclusion: The outcome of this study provides more accuracy with a margin of error of +/-2 months and can be utilized for our population with confidence in medico legal disputes

Role of ultrasonography and C.T scan in blunt abdominal trauma [BAT]

Objective: to evaluate the role of ultrasound and CT scan in the management of patients with blunt abdominal trauma [BAT] and to assess the diagnostic efficacy of ultrasonography in these patients

Material and methods: this prospective study was conducted in the Department of Diagnostic Radiology LUMHS, Jamshoro - Pakistan from July 2006 to June 2008. Ultrasonography was performed in 1000 patients with blunt abdominal trauma to detect the free fluid in peritoneum [haemoperitoneum] and visceral injuries. Sensitivity and specificity of ultrasonography were calculated by comparing the results with findings from computed tomography [CT] scan, diagnostic peritoneal levage and laparotomy

Results: out of 75 males and 25 females 60% had history of assault and 40 patients came with the history of road traffic accident. Ultrasonography was found to be 96.97% sensitive and 100% specific in detecting haemoperitoneum whereas it was 82.47% sensitive and 100% specific in diagnosing visceral injuries. Twenty-nine patients underwent laparotomy while the rest of the patients were managed conservatively

Conclusion: the ultrasound and CT scan play important role in making appropriate decision to select management option for patients with blunt abdomen trauma [BAT] and can reduce negative laparotomy rate