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Experience With Wood Lamp Illumination and Digital Photography in the Documentation of Bruises on Human Skin

Published on Mar 1, 2002in JAMA Pediatrics12.004
· DOI :10.1001/archpedi.156.3.265
Ev Vogeley4
Estimated H-index: 4
(University of Pittsburgh),
Mary Clyde Pierce21
Estimated H-index: 21
(University of Pittsburgh),
Gina Bertocci19
Estimated H-index: 19
(University of Pittsburgh)
Abstract
Bruising is very common in children. Examination of bruising can guide the clinician in ordering radiographic imaging studies of children who have suffered trauma. Additionally, bruising in infants and patterns of bruising that do not match the injury scenario offered by caretakers can raise the suspicion of abuse. This article reports preliminary experience with Wood lamp enhancement of faint bruises and visualization of bruises that are not visible. It describes the method for digital photography of bruises visualized in this way. Finally, it suggests future applications and areas of further study.
  • References (11)
  • Citations (41)
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References11
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Objective. The objective of our study was to collect data on the totality of recent skin injuries in normal children and adolescents, and to determine the relationship between the number of injuries, the age of the child, and the time of year in a temperate climate. Methods. The participants in this study were children and adolescents seen successively for a reason other than trauma over a period of 1 year, by the first author (J.L.), in a university medical center in Quebec City, Canada. The to...
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#1Naomi F. SugarH-Index: 13
#2James A. TaylorH-Index: 37
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Objectives To determine the frequency and location of bruises in normal infants and toddlers, and to determine the relationship of age and developmental stage to bruising. Design Cross-sectional survey. Setting Community primary care pediatric offices. Subjects Children younger than 36 months attending well-child care visits. Methods Prospective data collection of demographics, developmental stage, and presence and location of bruises. Any medical condition that causes bruises as well as known o...
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AIM—To obtain a prevalence rate and determine the distribution of accidental bruising in babies. METHODS—177 babies aged 6-12 months were examined naked to look for bruises. They were seen in health visitor hearing test clinics and child health surveillance clinics. The site, size, shape, and colour of bruises were recorded on a skin map, and the parent's explanation noted. Any other injury was recorded. Data collection included the baby's age, mobility and weight, demographic details, and healt...
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#1Thomas J. David (Georgia Bureau of Investigation)H-Index: 2
#2Michael N. Sobel (Allegheny County)H-Index: 1
After a brutal rape, which the victim survived, a bite mark was photographed and other evidence was collected. It was not until several months later when the bite mark became a critical piece of evidence, that the problem with its collection became apparent to the prosecutor. The photograph of the bite mark taken by law-enforcement officials at the time of the crime did not include a reference scale. Therefore the bite mark was of little evidentiary value. The authors subsequently examined the v...
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Recent investigation regarding the optical properties of human skin has lead to studies measuring autofluorescence, absorption, and reflectance of monochromatic light during exposure both in vitro and in vivo environments. The Stokes Shift deviation in absorbed and reflected light energy that occurs when skin is illuminated by 450 nanometer visible blue light can produce an augmentation in the appearance of pattern injuries when viewed through colored blocking filters. This paper demonstrates a ...
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The history of ultraviolet illumination in photography is discussed. Particular attention is devoted to the forensic aspects of ultraviolet photography as it relates to patterned injury on human skin. The authors discuss the theory underlying ultraviolet illumination of wounds on skin as well as the equipment required for this type of imaging.
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#1David R. RedsickerH-Index: 1
An examination of the practical methodology of forensic photography. It combines methods of photographic documentation with a practical step-by-step presentation. The author discusses the "how to" of basic photography (including techniques and equipment), shows the essentials of videography, and offers the fundamentals of aerial, underwater and surveillance photography as related to court evidence. The book includes a glossary of terms crucial in the preparation of legal reports.
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The use of ultraviolet light (UVL) to study and document patterned injuries on human skin has opened a new frontier for law enforcement. This article discusses the photographic techniques involved in reflective and fluorescent UVL. Documentation of skin wounds via still photography and dynamic video photographic techniques, which utilize various methods of UV illumination, are covered. Techniques important for courtroom presentation of evidence gathered from lacerations, contusions, abrasions, a...
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This project is an attempt to standardize a technique for ultraviolet (UV) photography of bite marks on human skin. It also deals with a technique for producing clinical bite marks on living human subjects and a review of the equipment, lighting source, scanning technique, filters, films, and recommended camera exposures and film development for reflective UV photographs for bite marks on human skin.
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Abstract Background It is standard practice to image concerning bruises in children. We aim to compare the clarity and measurements of bruises using cross polarized, infra-red (IR) and ultra-violet (UV) images to conventional images. Methods Children aged Results Twenty five children had 39 bruises. Bruises that were of low contrast, i.e. difficult to distinguish from surrounding skin, were also more diffuse, and less uniformity in vivo. Low contrast bruises were best seen on conventional and cr...
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Abstract When a child consultation center evaluates abused children, evidence of the abuse must be documented. Children who have suffered physical abuse often have bruises, which cannot be confirmed by visualization when the bruise has healed. In forensics, a method to confirm an old bruise by ultraviolet radiation is possible. However, long-term ultraviolet exposure can be harmful. In this study, we observed 15 bruises on healthy volunteer children using four kinds of light sources, including u...
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With the advent of digital cameras, there has been an explosion in the number of medical specialties using images to diagnose or document disease and guide interventions. In many specialties, these images are not added to the patient’s electronic medical record and are not distributed so that other providers caring for the patient can view them. As hospitals begin to develop enterprise imaging strategies, they have found that there are multiple challenges preventing the implementation of systems...
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Background Photographing injuries in the acute setting allows for improved documentation as well as assessment by clinicians and others who have not personally examined a patient. This tool is important, particularly for telemedicine, tracking of wound healing, the evaluation of potential abuse, and injury research. Despite this, protocols to ensure standardization of photography in clinical practice, forensics, or research have not been published. In preparation for a study of injury patterns i...
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The capacity of optical imaging methods to characterize biological tissue in general, and skin in particular, with high resolution and discrimination ability provides a very valuable tool in the reliable, noninvasive assessment of differences between normal and abnormal states, thus allowing meaningful clinical applications, including early diagnosis of disease. For such approaches to fully realize their potential, one must start from a good understanding of tissue properties, and an equally adv...
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Background To obtain forensic evidence of blunt trauma injury, physical examination (PE) is necessary but is only valid when an injury is visible. Identification of previously invisible injuries through the application of ultraviolet (UV) radiation is a phenomenon that has been known for decades, but to date has only drawn little attention in German legal medicine.
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This single-blinded, randomized validation study was conducted to evaluate whether fluorescence under alternate light sources (ALS) is sufficient to diagnose subclinical bruising (bruising not visible under white light). Standardized trauma was induced on randomly selected ventral forearms. On days 1, 7, and 14 investigators independently examined case forearms under white light for perceived bruising and under ALS for fluorescence and compared body maps. 56 case and 62 control forearms (n = 118...
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Alternate light sources are devices that produce visible and invisible light at specific wavelengths to allow for enhanced visualization of fluorescent substances. These devices (which include Wood's lamp and blue light) are often used in forensics for evidence collection and can be quite useful to physicians in the medical evaluation of suspected physical or sexual assault. An understanding of the proper applications, as well as the limitations, of each alternate light source is imperative to c...
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