Techniques and Applications in Forensic Medicine: From Clinical to Pathology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 30 November 2026 | Viewed by 874

Editor

Special Issue Information

Dear Colleagues,

Forensic medicine is a multidisciplinary field that applies medical knowledge to legal investigations, bridging clinical practice and pathological examination. It plays a crucial role in both living individuals (clinical forensic medicine) and deceased persons (forensic pathology), supporting the justice system through scientific analysis and expert interpretation. Within the scope of Diagnostics, this Special Issue focuses on the diagnostic methodologies and technological innovations that underpin forensic assessments, emphasizing their accuracy, reliability, and evidentiary value.

In clinical forensic medicine, physicians evaluate victims and suspects in cases involving assault, sexual violence, domestic abuse, child maltreatment, intoxication, and other forms of trauma. Key diagnostic techniques include detailed physical examinations, injury documentation through standardized photography, collection of biological samples for genetic and toxicological analysis, and age estimation. The precision of these diagnostic tools, coupled with proper evidence handling and chain of custody, is essential to ensure their admissibility and impact in court.

Forensic pathology focuses on determining the cause, manner, and time of death. The primary diagnostic technique is the medico-legal autopsy, which involves external and internal examination of the body. This is increasingly augmented by complementary diagnostic methods such as histopathology, toxicology, advanced radiology (including post-mortem computed tomography and magnetic resonance imaging), forensic anthropology, and molecular biology techniques like DNA analysis and proteomics. These tools not only help identify victims and reconstruct events but also enhance the diagnostic accuracy in clarifying suspicious or unexplained deaths.

Advances in technology have significantly improved the accuracy and reliability of forensic investigations. Innovations in imaging, digital documentation, genetic profiling, and minimally invasive sampling techniques are transforming both clinical assessments and post-mortem analyses, paving the way for more objective and evidence-based forensic diagnoses.

Overall, forensic medicine serves as a critical interface between medicine and law, ensuring that medical findings are accurately interpreted and effectively applied within judicial processes. This Special Issue invites contributions that explore cutting-edge diagnostic techniques and their applications in forensic medicine, with the aim of advancing the field's scientific foundation and practical utility.

Prof. Dr. Angelo Montana
Guest Editor

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Keywords

  • forensic medicine
  • clinical forensic medicine
  • forensic pathology
  • autopsy
  • DNA analysis
  • trauma
  • forensic imaging
  • post-mortem radiology
  • toxicology
  • cause of death

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Published Papers (2 papers)

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Research

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14 pages, 2372 KB  
Article
Redefining the Post-Mortem Investigation of Sudden Cardiac Death: Systematic Cardiac MR with Macroscopic and Histological Correlation from the Friuli Venezia Giulia Regional Registry
by Lorenzo Pagnan, Alessandro Sarno, Matteo Cesarotto, Luca Salice, Tommaso Bruscagin, Davide Radaelli, Gianfranco Sinagra, Anita Galic Mihic, Maria Assunta Cova and Stefano D’Errico
Diagnostics 2026, 16(13), 2067; https://doi.org/10.3390/diagnostics16132067 - 1 Jul 2026
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Abstract
Objectives: Sudden cardiac death (SCD) is a leading cause of mortality, accounting for approximately 50% of all cardiovascular deaths and 20% of all-natural deaths in Western countries. In individuals over 50 years of age, coronary artery disease (CAD) is responsible for more [...] Read more.
Objectives: Sudden cardiac death (SCD) is a leading cause of mortality, accounting for approximately 50% of all cardiovascular deaths and 20% of all-natural deaths in Western countries. In individuals over 50 years of age, coronary artery disease (CAD) is responsible for more than 80% of cases, whereas in younger subjects SCD is more frequently associated with non-ischemic myocardial diseases, including hypertrophic cardiomyopathy (HCM), arrhythmogenic cardiomyopathy (ACM), dilated cardiomyopathy (DCM), and myocarditis. Additional causes in young adults include coronary artery anomalies and primary arrhythmic disorders related to channelopathies. This study evaluated the diagnostic performance of post-mortem cardiac magnetic resonance imaging (PM-CMR) in identifying morphological substrates underlying SCD in formalin-fixed explanted hearts, with particular attention to the concordance between PM-CMR findings and autopsy results in cases of sudden coronary death. Material and Methods: We retrospectively reviewed 110 PM-CMR examinations from the Regional Register of Sudden Cardiac Death of Friuli-Venezia Giulia, of which 101 were included in the final analysis. Results: PM-CMR detected pathological findings in 60 hearts (59%), including acute ischemic lesions in 39 cases and other conditions, such as hypertrophic cardiomyopathy, chronic fibrotic ischemic changes, and adipose metaplasia in 21 cases. A good agreement between PM-CMR and autopsy findings was observed (Cohen’s kappa = 0.8). Conclusions: Overall, PM-CMR proved effective in identifying relevant morphological and signal alterations, supporting conventional autopsy. Despite some limitations, particularly in hyperacute ischemic lesions, PM-CMR appears to play a promising role in the diagnostic work-up of SCD and in supporting family screening programs for primary prevention. Full article
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Review

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21 pages, 340 KB  
Review
A Forensic Approach to Perioperative Deaths After Non-Cardiac Surgery: A Narrative Review
by Lucia Tattoli, Agnese Accogli, Angelo Montana, Irene Pradelle, Andrea De Gasperi and Margherita Neri
Diagnostics 2026, 16(17), 2692; https://doi.org/10.3390/diagnostics16172692 - 24 Aug 2026
Abstract
Globally, approximately three hundred million individuals undergo non-cardiac surgery each year. Perioperative mortality results from a complex interplay between patient-related factors and procedural variables, including both surgical and anesthetic aspects. Although cardiac surgery has a well-established risk profile for acute cardiovascular events, major [...] Read more.
Globally, approximately three hundred million individuals undergo non-cardiac surgery each year. Perioperative mortality results from a complex interplay between patient-related factors and procedural variables, including both surgical and anesthetic aspects. Although cardiac surgery has a well-established risk profile for acute cardiovascular events, major non-cardiac surgery also carries significant—yet often underrecognized—cardiovascular risks. Approximately half of postoperative deaths following non-cardiac procedures are attributable to cardiovascular complications. Surgical and anesthetic stress responses may induce myocardial injury through several pathophysiological mechanisms. However, the absence of a universally accepted definition of perioperative myocardial injury complicates both diagnosis and management. Furthermore, these injuries frequently occur without symptoms, making them clinically silent and often undetected. Consequently, unexpected postoperative deaths may occur and may lead to allegations of medical malpractice. We conducted a narrative review of existing literature on perioperative myocardial injury and its implications for forensic investigation and medico-legal assessment. This paper highlights the importance of a comprehensive forensic evaluation of perioperative deaths, integrating clinical documentation, autopsy findings, histopathological evidence and ancillary investigations to support accurate medico-legal assessment, recognizing that no single element is sufficient to establish the cause of death in all cases. Four illustrative case studies are presented to demonstrate the medico-legal challenges associated with these events. A structured forensic investigation is essential for accurately determining the cause of death and for distinguishing preventable medical errors from unavoidable adverse outcomes within the context of complex perioperative care. Full article
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