Radiological findings at a South African forensic pathology laboratory in cases of sudden unexpected death in infants

Objectives. The work serves as a preliminary evaluation of the utility of full-body radiography in examining cases of sudden unexpected death in infants (SUDI). Setting. This paper reviews findings from full-body digital radiography in cases of SUDI in 2008 at the Salt River Forensic Pathology Laboratory in Cape Town. Subjects. One hundred and ninety-two cases of SUDI referred to the mortuary and undergoing full-body digital radiography were reviewed. Design. Imaging reports were cross-referenced with death registry data. Manner of death, cause of death, whether an autopsy had taken place, and radiological findings, were recorded and analysed. Results. The absence of bone fractures was recorded as an imaging finding in 40% of cases. The most common type of imaging pathology was lung disease. In cases where autopsies were performed and pathology was found on imaging, the findings of the two methods of examination were consistent. Conclusions. Imaging might have served to assist cause-of death determination based on case history, and therefore full-body radiography could improve the workflow in busy forensic pathology laboratories. More detailed and consistent recording of imaging findings is required before stronger conclusions may be drawn regarding the utility of full-body digital imaging of paediatric cases in forensic pathology laboratories.