Radiographs interpretation by forensic pathologists: a word of warning.

In child deaths investigation, radiologic examination is particularly important in the diagnosis of child abuse. In the province of Quebec, Canada, all autopsies for suspicious deaths are performed at a centralized forensic laboratory where, because of budget restrictions, forensic pathologists rely on their own knowledge for radiographs interpretations. To assess the validity of this radiologic examination by nonradiologist forensic specialist, we reviewed all cases of child death on a 1-year period. A total of 20 cases were reviewed by an experienced pediatric radiologist, and this interpretation was compared with pathologist's conclusions. Forensic pathologists missed an important finding in 3 positive cases. Yet, none of those missed findings would have significantly changed the cases outcome, because other autopsy findings had already oriented the final diagnosis. Nevertheless, this result is alarming. In a general context of financing problems, it can be appealing to management team to restrict access to external consultants. This study is important in reminding that such money savings do not come without a decrease in quality.