Table Of ContentA
Radiologic Atlas
of
ABUSE, TORTURE,
TERRORISM, AND
INFLICTED TR AUM A
© 2003 by CRC Press LLC
A
Radiologic Atlas
of
ABUSE, TORTURE,
TERRORISM, AND
INFLICTED TR AUM A
B.G. Brogdon, M.D.
Hermann Vogel, M.D.
John D. McDowell, D.D.S., M.S.
with contributions by
Richard Dirnhofer
Joel E. Lichtenstein
James M. Messmer
Gary S. Silverstein
Michael J. Thali
Peter Volk
CRC PR E S S
© 2003 by CRC Press LLC
Boca Raton London New York Washington, D.C.
Library of Congress Cataloging-in-Publication Data
A radiologic atlas of abuse, torture, terrorism, and inflicted trauma / B.G. Brogdon,
Hermann Vogel, John D. McDowell; with contributions by Richard Dirnhofer ... [et al.] editors.
p. cm.
Includes bibliographical references and index.
ISBN 0-8493-1533-6 (alk. paper)
1. Forensic radiography—Atlases. 2. Wounds and injuries—Imaging—Atlases. 3.
Forensic sciences—Atlases. I. Brogdon, B.G. (Byron Gilliam) II. Vogel, H. (Hermann)
III. McDowell, John D.
RA1058.5 .R336 2003
617.1′0757—dc21 2002191168
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© 2003 by CRC Press LLC
Dedication
with enduring love to my precious Babs,
who meets all of life’s challenges
with courage, grace, and unfailing good humor.
B.G.B.
to those who suffer,
to those who report,
to those who help.
H.V.
to my wife, Linda,
for her love, patience, and encouragement;
to my children, Michael, Joshua, Megan, and Marin,
for their understanding and support;
to my students, who make every day a new experience.
J.D. McD.
© 2003 by CRC Press LLC
Preface
This book is about aggression, in its many forms, by colleagues, both published and unpublished, who have
people against the persons of others, ranging from the shared their material with us and, consequently, with our
tiniest, most helpless infant to entire population groups. readers. Whenever possible we have properly and grate-
Man is the most indiscriminate animal in aggressive fully acknowledged these contributions. Unfortunately,
behavior, and the most innovative, his armamentarium the origin of some of our images are lost to record and
ranging from the primitive fist to the most sophisticated memory. For these oversights we do apologize while again
instruments of destruction. expressing our gratitude.
The results of aggression may be hideously obvious Even when technically perfect, these pictures are not
or may be entirely concealed from casual inspection, to pretty. Our purpose here is not to celebrate the effects of
be revealed only by exploration of the hidden recesses of aggression. Rather, it is our fondest hope that an atlas such
the mind by psychiatric evaluation, or by exploration of as this will be impossible to accumulate in later decades of
the inner recesses of the body by the radiologic method. this century we now begin. If our images are seen as dis-
The radiologic images documenting aggression may turbing, repulsive, and vituperative against aggression in
be suboptimal, often being acquired by inexpert persons any form, then our efforts will have been amply rewarded.
under difficult, sometimes even surreptitious, conditions. However, to eschew aggression is not to embrace pacifism.
Hence, we regret that some of the illustrations we present Indeed, the fight against aggression, whether individual or
are not better, but we do not apologize for them. Most of collective, is a worthy and noble cause for all.
the images presented are from the files of the editors,
but these have been supplemented by the generosity of B.G.B.
© 2003 by CRC Press LLC
Acknowledgments
Already we have thanked in the Preface the generous sanctions. Since my material was collected during some
donations of material from colleagues and have acknowl- 20 years and I received images, comments, and support
edged them appropriately either in captions or on the from many colleagues, a selection is unavoidable. I apol-
Contributors page. We will again apologize to those ogize to those who contributed but who are not mentioned.
donors no longer identifiable because of faulty records or, I thank, in Mexico, Dr. Gonzales-Morantes, head of
more often, faulty memory. the x-ray department, and Dr. Pineiro, the former dean of
There are many others whose contributions are less the medical faculty, as well as president, of the Univer-
tangible but no less significant. These are colleagues who sidad Autonoma de Nuevo Leon (UANL) in Monterrey;
have sparked, encouraged, and nurtured my interests in in Peru, Dr. Flores, Dr. Villanueva-Meyer (former pres-
the field of forensic sciences. So many members of the ident of Peruvian Radiological Society), Dr. Hidalgo,
American Academy of Forensic Sciences have strongly and Professor Ballon-Medina; in Columbia, Dr. Varon,
influenced and forwarded my efforts in this field that I Dr. Rotlewickz, Dr. Rivera, Dr. Reina, Dr. Prado, Dr.
dare not try to name them for fear of embarrassing omis- Diazgranados, Dr. Perez, and especially Dr. Borrero; in
sion. However, among those unsung supporters I must Thailand, Dr. Perkanan and Professor Notasut; in China,
make an exception to mention John McDowell, one of my Professor Bai Run-Xian (chief of radiology in the Tianjin
co-editors in this project. John has been a warm friend as Cancer Hospital), Professor Sun, Dr. Liu Pei-Fan, Dr. Xi-
well as a supportive colleague. Xhan Hao, and Wand Young-Uman; in South Africa,
My other co-author, Hermann Vogel, and I met Dr. Tobias (Hilbroh Hospital in Johannesburg), Professor
through our books on a common interest — the radiology Altini, Professor Evans, Professor Lownie, Dr. Classens,
of forensic problems, aggression, and violence. He has and Dr. Toysz (School of Dentistry of the University of
been delightful to work with and shares with all of us his Witwatersrand); in Zimbabwe, Professor Levy and Mrs.
exceptional, indeed unequalled, collection of radiologic Kaupny in the Perirenatwa Hospital, Harare; in Tansania,
material in this field. Dr. Ndosi and Dr. Llweno of the Muhimbili Hospital, Dar
We are enormously indebted to Tollef Tollefson, our es Salaam; in Egypt, Dr. Dekan, Professor Rizh, Professor
departmental photographer, who has created the major Hanssanein, Dr. Ramadan, and Dr. Mahmoud El Sheikh,
portion of this picture book from an assortment of images in faculty of medicine in Alexandria; in Algiers, Dr. Yaher
varied format, many of them suboptional in the original form. (vice president of the Algiers Society of Radiology),
Rose Jones has typed and retyped the manuscript from Professor Hatani, and Professor Hamad.
all contributors, and Michele Lockley, Vanessa Brown, In Germany, I thank the German diplomatic service
Gerri Vance, and Thomie Brown have all pitched in when for helping me, especially my former classmate, Herr
needed. I am thankful for their essential contribution. Starnitzky, Dr. Hinrichsen, Herr BoudréëGröger, former
Although I am in emeritus status, my department German ambassador to Vietnam, and Herr Vollbrecht from
chairman, Dr. Steven K. Teplick, makes available office the Goethe Institute. I am also grateful to my academic
space and other facilities and personnel necessary to sup- teacher, Professor Büchelerand, my colleagues, Dr. von
port my continued scholarly endeavors. Otherwise, an Wechmar, Dr. Pleser, and Dr. Brinckmann. For their sup-
undertaking such as this would be impossible. port, I would also like to thank Mr. Lohmann, Mr. Becker,
Lastly I am indebted to CRC Press for making this Dr. Mellmann, and Professor Böhme, medical director of
idea a reality. I particularly appreciate the confidence and the General Hospital Hamburg, Ochsenzoll; Mrs. Khan
support of Becky McEldowney, senior editor, and the for- and Mrs. Weber, my secretaries; and my colleague,
bearance and expertise of Sara Kreisman, manager, edi- Dr. Bartelt, of St. Georg Hospital in Hamburg, who under-
torial project development. took the difficult task of correcting my English manuscript
and translating difficult passages. I am obliged and thankful
B.G.B. to Amnesty International, which took charge of me during
my travels and created an exhibition that has been shown
to the nonmedical public in Paris, Vienna, Berlin, Hamburg,
In the first place, I thank all those who gave me their and 15 other places in cooperation with Mr. Henning,
material and asked me not to mention their names. They director of the German Röetgenmuseum, and his co-worker,
did this because they were afraid of repercussions and Mr. Bush. I thank them all for their interest and support.
© 2003 by CRC Press LLC
In Hamburg, I thank Professor Püschel, director of the In France, Professor Fauré and Professor Menantheau
Institute of Forensic Medicine of the University of Hamburg, allowed me to use their cases; Dr. Hasebrouqc helped me
and Dr. Hayek of the Children Hospital, Wilhelmstift. I greatly; and Professor Cabanis, secretary of the Societé
also acknowledge Dr. Niestroj and Dr. Oswald of General d’ Imagerie Médico-Légale, encouraged me to continue.
Hospital St. George, Dr. Szieslack of General Hospital Lots of thanks to them.
Barmbeck, and Professor Heller of University Kiel for In general, the figures of the book come from radio-
their cooperation and contributions. graphs and slides that I photographed all over the world.
I got insights in torture by visiting the Rehabilitation These photographs were evaluated by my colleagues
Center for Torture Victims (RCT or AVRE) in several and myself in Hamburg, frequently in the form of medical
countries. I admire and thank my colleagues and their dissertations, especially those made by Dr. Bergunde,
collaborators for their contributions, especially Dr. Dr. Forquignon, Dr. Hartmann, Dr. Hushahn, Dr. Jung,
Genefke and Dr. Rasmussen from RCT in Copenhagen; Dr. Kintzel, Dr. Okkovat, Dr. Olrogge, and Dr. Lotz. I
Dr. Jaffe from AVRE in Paris; Dr. Veli Lök from Izmir, thank them for contributing.
Turkey; Dr. Hinshilwood from London; Professor
Jakobsson from Stockholm; and Dr. Graesner from Berlin. H.V.
This also holds true for Dr. Quincke and Dr. Mason from
the World Health Organization in Geneva.
The radiology of victims of the war in former I acknowledge my mentors during my residency and fel-
Yugoslavia was presented to me in Zagreb by Professor lowship at the University of Texas Health Sciences Center,
Montani, Professor Simunic, Dr. Skrbic, Dr. Fattorini, Dr. Dr. Ole Langland and Bob Langlais, for assisting me with
Cop, and Dr. Bumci; in Belgrad, Professor Lisanin, Pro- cases during my early career in oral and maxillofacial
fessor Kamenica, Dr. Nikolic, Dr. Pervulou, Dr. Lucac radiology. I also acknowledge the instruction and case
Stevan, Dr. Elakovic, Professor Tadic, Dr. Roganovic, and experience that came through the exceptional teaching of
Dr. Slobodan; the radiology of poison gas effects was Dr. Vincent J.M. Di Maio at the Bexar County (Texas)
analyzed by my co-workers and I in Recklinghausen, Medical Examiner’s Office. Special appreciation goes to
Germany, with Professor Firusian and with Dr. Sohrabpour, my colleagues at the University of Colorado Health Sci-
Teheran, Iran. I am thankful and obliged to each of them. ences Center, Dr. Eric Miller (director, general practice
The radiology of terrorism was shown to me in North- residency) and Dr. Mike Savage (chair, oral and maxillo-
ern Ireland by Dr. Laird, Dr. Brown, Mr. Hood, M.D., Dr. facial surgery) for their ongoing assistance with our many
Lavery, Dr. McKienstry, and Dr. Thompson, and, in Israel, domestic violence cases.
by Dr. Donchin and Professor Barsiv, Hadassah University
Hospital, Jerusalem. I admire their work and thank them. J.D. McD.
© 2003 by CRC Press LLC
Editors
Gil Brogdon, M.D., grew up on an Arkansas farm unsul- in 1972 he qualified as a specialist and became Privat
lied by electric lights or indoor plumbing. He attended the Dozent (habilitation and venia legendi). In 1973, he became
state university, earning two baccalaureate degrees. In 1952, vice director of the radiological clinic of the University
he received his M.D. from the University of Arkansas of Hamburg, and in 1978, professor of the faculty of
School of Medicine where he was later named a Distin- medicine. In the same year he also became head of the
guished Alumnus. His radiological training, which began x-ray department of Ochsenzoll Hospital, Hamburg, one
in Arkansas, was completed at the Bowman-Gray College of the academic and teaching hospitals of the University
of Medicine from where he later received a Distinguished of Hamburg. In 1998, he was appointed the head of the
Achievement Award. He was certified by the American Albers-Schönberg-Institut, the x-ray department of St.
Board of Radiology in 1956. Georg Hospital, Hamburg, also one of the academic and
After serving as a Regular Officer in the U.S. Air Force, teaching hospitals of the University of Hamburg, famous
Dr. Brogdon began a 43-year academic career, which has for its contributions to the development of radiology and
included appointment as radiologist-in-charge of diagnos- for the pioneers of x-ray applications.
tic radiology at Johns Hopkins and as professor and chair- In 1982, he was visiting professor at the UANL,
man of the departments of radiology at the University of Monterey, Mexico, where he started to collect x-ray
New Mexico and the University of South Alabama. pathology typical for developing countries, which led to
Dr. Brogdon is past president and life member of the his works on x-ray diagnostics of violence (war, torture,
Southern Radiological Conference, past president and crime). Each year, he visits one to three third world coun-
gold medalist of both the Association of University Radi- tries in search of typical and extraordinary pathology.
ologists and the American College of Radiology. Dr. Vogel has published more than 250 articles in
He also has been awarded the Gold Medal of the German, as well as English, French, Spanish, Japanese,
American Roentgen Ray Society, the Schinz Medal of the and Arabic. He has authored 18 books and 1 leaflet col-
Swiss Society of Medical Radiology, the Medal of Honor lection. By invitation he has given lectures and postgrad-
of Leopold-Franzens University of Innsbruck, the Medal uate courses in more than 30 countries such as Japan,
of the International Skeletal Society, and the Austrian Vietnam, Peru, Columbia, Serbia, and Bosnia. His scien-
Cross of Honor for Science and Art, First Class. tific interest is in radiation protection, postoperative radi-
Dr. Brogdon’s interest and experience in forensic radi- ology, radiology of tropical diseases, and x-ray diagnostics
ology spans almost four decades. He has received the Hunt of violence. He is a member of the working group for the
Award and the Distinguished Fellow Award and Medal new x-ray legislation in Germany, vice-chairman of the
from the American Academy of Forensic Sciences. He working group for the radiation protection at the NAR/DIN
serves on the editorial board of the Journal of Forensic in Germany, and a member of the directory of the Societe
Sciences and is a member of the board of trustees of the Medico-Legale d’Imagerie in Paris. He has been invited
Forensic Sciences Foundation. as an expert to the hearings of the European Union and the
Dr. Brogdon is the author or co-author of 280 publi- German authorities. Furthermore, he coordinates research
cations including the 1998 classic, Forensic Radiology, with physicists from DESY (the German electron synchro-
published by CRC Press. tron) and mineralogists from the University of Hamburg,
Hermann Vogel, M.D., born July 7, 1942, grew up investigating pearls and precious stones and projects for
in Hamburg, Germany. As a student, he excelled in natural diminishing the radiation exposure, both of which have
sciences as well as modern and classical languages. He led to patents and were honored with prizes. His work has
went on to the medical school at the University of Hamburg, resulted in cooperation with Amnesty International. As a
Germany, and received a scholarship from the French member of different human rights groups, he was in Chad,
government to Montpellier, the second oldest medical Africa, to investigate the crimes of the former government.
school in Europe. He also studied law in Hamburg and In addition, an exhibition of his collection of x-rays,
Heidelberg. After receiving his degree in medicine, he called, “X-ray Diagnostic of Violence” for the nonmedical
served in the German Navy and then worked in Sweden public was created, which was shown in more than 20
in the department of anesthesia and dialysis, General Hos- places such as Paris, Berlin, Amsterdam, and Vienna.
pital of Vanersborg. He started his university career in the Dr. Vogel is married to a radiologist and has four
radiological clinic of the University of Hamburg, where children.
© 2003 by CRC Press LLC
