(d) Photographs should be comprehensive, and must confirm the presence and details of all demonstrable signs of injury or disease commented upon in the autopsy report. Photographs of injuries should include a scale with the autopsy number (e) After the body has been washed or cleaned, identifying facial features should be portrayed with photographs of a full frontal aspect of the face and right and left profiles of the face. 256. The role of cross-sectional scanning has been discussed at Paragraphs 158 to 163 above. If it is available, then CT scanning of the whole body enclosed in the body bag should be undertaken. (If this is done, further consideration of the need for plain X-rays will still be needed). In the likely event that cross-sectional imaging is not available, the body should be radiographed with plain X-rays before it is removed from its packaging. X-rays should be repeated both before and after undressing the body. Fluoroscopy (looking for foreign bodies such as projectiles) may also be performed.111 The following X-rays may also be required: (a) Dental X-rays may be necessary for identification purposes (b) Any skeletal system injury should be documented by X-ray. Skeletal X-rays may also record anatomic defects or surgical procedures. Check especially for fractures of the fingers, toes and other bones in the hands and feet (c) X-rays should be taken in gunshot cases to aid in locating the projectile(s). Any projectile or major projectile fragment seen on an X-ray must be recovered, photographed, recorded as an exhibit and secured. Other radioopaque objects (such as knife fragments) should also be documented with X-rays, removed, photographed, recorded as exhibits, and secured. If necessary for the purposes of identification, metallic prostheses must be removed and examined, and any identifying features recorded, photographed and secured. Any pacemakers must be removed, especially if cremation is to take place, as they will explode in a fire (d) Skeletal X-rays can assist in determining the age and developmental status of children and young adults. 111 2. The clothed body 257. Before clothing is removed, the clothed body should be photographed. 258. If it has not already been done, and is indicated by the circumstances, the hands should now be swabbed for firearm discharge residues. If not done at the scene, the clothed body should be carefully inspected for any traces that might constitute evidence. If any traces are found, they should be described, retrieved, recorded as exhibits and secured. 259. The clothing should be carefully removed (preferably without damage) over a clean sheet or body pouch. The clothing and any jewellery should all be individually examined, described, recorded, labelled, photographed and secured. 3. External examination 260. The external examination, focusing on a search for external evidence of injury, is in most cases the critically important part of the autopsy. (a) All of the body area must be photographed (b) The body must be examined and the deceased’s apparent age, height, weight, sex and gender, head-hair style and length, nutritional status, muscular development, and colour of skin, eyes and hair (head, facial and body) must be examined and recorded (c) In babies, the head circumference, crown-rump length and crown-heel length should also be measured (d) The degree, location and fixation of rigor and livor mortis should be recorded (e) Body warmth or coolness and state of preservation should be noted as should any decomposition changes, such as skin slippage. The general condition of the body should be evaluated and note taken of adipocere formation, maggots, eggs, pupae, or anything else that suggests the time or place of death (f) With all injuries, their location (related to static anatomic landmarks), size, shape, surrounds, pattern, contents, colour, course, direction and depth must be recorded. Injuries resulting from therapeutic measures should be distinguished wherever possible from those unrelated to medical treatment This Section has been written on the basis that cross-sectional imaging or scanning such as CT scanning or MRI scanning is not available. If it is available, it should be used, bearing in mind the discussion above. Some plain X-rays may still be required. 39