Radiology of torture.
OBJECTIVE
Although there are different definitions of torture, there is no contradiction that torture exists. Changes resulting from torture are shown to demonstrate which findings can be visualized with X-rays.


METHODS
The findings come from rehabilitation centers for victims of torture, collections of others and from personal observations. They are documented with plain films, scintigraphy, computed tomography, and MRI.


RESULTS
On fingers, hand, and arm, and on toes, foot and leg, imaging can visualize changes and pathologies which are characteristic for preceding torture. On head, neck, and trunk, this is only rarely the case; this is understandable, when one considers that force having been directed against these regions of the body will more often be deadly than that applied on limbs only. Special forms of torture with the use of water and electricity are also described. It is pointed out that multiple forms of torture do not leave traces, which might be made visible by diagnostic imaging. The cases are part of a selection: the victims have survived (which means that these types of torture permitted survival; injuries of hand and foot do not endanger the survival as opposed to stab wounds to the head, chest, and abdomen, into the anus and the genitals, which are often mortal. Mutilation by torture motivates the torturer to eliminate any proof of his actions and to kill the victim. Public interest induces a selection of methods, which leave no traces. Possibly (and hopefully) some special forms of torture, which use chemical substances that act on the psyche and the central nervous system, might become visible by functional MRI in the near future.


CONCLUSIONS
Torture is likely to occur when findings are seen to be typical or characteristic forms of torture, when age of fractures and pattern of beatings and other injuries corroborate the indications of the victim, and when these findings correspond to the procedures known from the region of application the organization/group/militia, which is said to have executed the torture.
Vogel
H
H
Asklepios Klinik St. Georg Röntgenabteilung, Lohmühlenstrasse, 5 D-20099, Hamburg, Germany. Hermann.vogel@ak-stgeorg.lbk-hh.de
Schmitz-Engels
F
F
Grillo
C
C
D006801:Humans; D038622:Internationality; D011859:Radiography; D011871:Radiology; D014104:Torture / Q000145:classification*; D014857:Warfare; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*