Radiologic identification of unknown human remains

During the 15 months from April 1978 through July 1979, 3964 cases were referred to the City of St. Louis, Office of the Medical Examiner. Of these, 71 (1.8%) required investigation to establish identification (ID). All cases were rigorously investigated to establish the most scientifically sound ID possible. In addition to evidence from the scene, fingerprint, dental, and X-ray studies were attempted. Fifty (80.4%) individuals were scientifically identified, 17 (24%) were circumstantially identified, and 4 (5.6%) remain unidentified. Thirty (60%) of the 50 scientific IDs were by comparison of postmortem and premortem radiographs. Positive ID was accomplished in 22 cases of decomposition, 4 fire victims, 2 inadvertent body misidentifications, 1 submersion victim, and 1 suicide. Although all regions of the body were useful for ID, chest, skull, and abdominal radiographs were most frequently helpful. Anatomic, disease, and postsurgical features provided the unique features necessary for identification.