International Journal of Legal Medicine

, Volume 133, Issue 4, pp 1149–1158 | Cite as

Radiological investigation of gunshot wounds: a systematic review of published evidence

  • Arianna Giorgetti
  • Chiara Giraudo
  • Alessia Viero
  • Marco Bisceglia
  • Amalia Lupi
  • Paolo Fais
  • Emilio Quaia
  • Massimo Montisci
  • Giovanni Cecchetto
  • Guido VielEmail author



Despite the constantly growing popularity of radiological imaging in forensic pathology, a systematic review investigating the efficiency and limits of radiological techniques, in comparison to forensic autopsy, was still missing.


The present review aims at providing an overview on the current role of radiology in the forensic investigation of fatal gunshot wounds without any restriction to specific radiological techniques.

Material and methods

A systematic literature search on three databases (PubMed, Web of Science, and Science Direct) was performed until December 2017. The Oxford Centre for Evidence Based Medicine (OCEBM) grading system for levels of evidence was applied, in order to weigh published evidence.

Results and discussion

Eighty-six papers (1.64% of the records) were included. Despite the quite limited general level of evidence, which contrasts with the abundance of the scientific literature on this topic, several recommendations/statements, coupled to their OCEBM grade, were distilled as for the identification of retained bullets, gunshot wounds detection, diagnosis of entrance and exit wounds, trajectories and internal injury detection and estimation of the firing distance.


Imaging radiological technologies represent the present and future of wound ballistics. However, traditional, micro and molecular imaging techniques require further validation through blinded cross-sectional studies with appropriate reference standards (e.g. forensic autopsy).


Forensic pathology Forensic radiology Terminal ballistics Firearm Systematic review 


Supplementary material

414_2019_2071_MOESM1_ESM.docx (255 kb)
ESM 1 (DOCX 255 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Arianna Giorgetti
    • 1
  • Chiara Giraudo
    • 2
  • Alessia Viero
    • 1
  • Marco Bisceglia
    • 1
  • Amalia Lupi
    • 2
  • Paolo Fais
    • 3
  • Emilio Quaia
    • 2
  • Massimo Montisci
    • 1
  • Giovanni Cecchetto
    • 1
  • Guido Viel
    • 1
    Email author
  1. 1.Department of Legal and Occupational Medicine, Toxicology and Public HealthUniversity of PadovaPadovaItaly
  2. 2.Institute of Radiology, Department of Medicine (DiMED)University-Hospital PadovaPadovaItaly
  3. 3.DIMEC, Department of Medical and Surgical SciencesUniversity of BolognaBolognaItaly

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