Imaging of musculoskeletal injury: timing estimation and medico-legal issues

Radiol Med. 2025 Jun;130(6):921-933. doi: 10.1007/s11547-025-01990-4. Epub 2025 Mar 28.

Abstract

Musculoskeletal imaging plays a pivotal role in the evaluation of trauma, with applications spanning medical, forensic, and insurance contexts. Precisely dating musculoskeletal injuries is vital for reconstructing the timeline of events leading to trauma and verifying their accuracy. In forensic medicine, radiologists are frequently called upon by law enforcement and insurance companies to estimate the age of such injuries. This review aims to provide an overview of musculoskeletal imaging findings that can be used in medico-legal issues related to trauma to reach a comprehensive understanding of the causal relationship between the traumatic event and the clinical findings, with a particular focus on assessing causality, timing estimation and post-traumatic injury and impairment. Imaging plays a pivotal role in the precise and comprehensive evaluation of musculoskeletal traumatic injuries, with applications extending from immediate clinical care to legal and insurance considerations. Through various imaging modalities, it is possible to estimate the time elapsed since the injury and assess the impact of any pre-existing conditions. Effective collaboration between the forensic physician and the radiologist is essential to accurately determine the causal link between the injurious event and the resulting damage. This interdisciplinary approach ensures appropriate compensation and addresses the complex forensic aspects involved.

Keywords: Causality; Forensic; Injury; Medico-legal issues; Musculoskeletal imaging; Trauma.

Publication types

  • Review

MeSH terms

  • Diagnostic Imaging*
  • Forensic Medicine* / legislation & jurisprudence
  • Humans
  • Musculoskeletal System* / diagnostic imaging
  • Musculoskeletal System* / injuries
  • Time Factors
  • Wounds and Injuries* / diagnostic imaging