Monday 10 October 2011

Emedinews:Insights on Medicolegal issues:What are patterned bruises?

The extent and severity of violence or force used may be determined from the size and swelling of bruise

• The examining doctor must document the dimension /shape/size of bruise in the medicolegal report as it may connect the victim and the object or weapon used in the specific case, e.g., chain, cane stick, rifle butt, boots, ligature, vehicle etc.
• The age of injury can be detected by the status of color of bruise; the extent and severity of violence or force used may be determined from the size and swelling of bruise; character and manner of the injury may be known from its distribution over the body.
• Bruising of the arm may indicate restraining of the victim.
• Bruising of the shoulder blades indicate firm pressure on the body against the ground or other resisting surface.
• In manual strangulation, the position and number of bruises and nail marks may indicate the method of attack and the position of the assailant.
• Patterned bruises on chest/neck and mouth are very important in diagnosing resuscitative injury in medicolegal cases, which may be invariably misconstrued by the doctor as indicative of manual strangulation/smothering.
• Patterned bruises are an important tool to diagnose torture injury and very commonly appreciated in sole/flexor aspect of hands/buttock and back of thighs by doctors.

(Contributed by Dr Sudhir Gupta)

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