A/69/387 symptoms that may indicate that torture or other ill-treatment has taken place. Where the screenings identify such symptoms, a full article 12 Convention against Torture investigation must be conducted, including by offering the detainee an immediate full forensic evaluation in accordance with the Istanbul Protocol. It is essential that the detainee meet the forensic expert in a setting that is free of any surveillance or pressure and that the evaluation takes place in full confidentiality. The Special Rapporteur reiterates that it is of utmost importance that prison authorities, police, military and prison health professionals provide medical reports in a timely manner. Resources 41. The Special Rapporteur notes that Governments often argue that a high standard of forensic evidence is out of the reach of States with limited resources. The Special Rapporteur agrees that good forensics are resource -intensive, but that does not justify not investing at all resource-poor States or areas. As already noted, many symptoms attributable to torture or other ill-treatment are not physical. In those cases, psychological assessment displaces medical evaluation as the main source of information. Psychological detection requires adequate training and time but much less investment in infrastructure than medical forensics. In countries where there is widespread physical torture, diagnosis can rely on a careful clinical examination with special emphasis on dermatology and rheumatology, as well as traumatology, aspects. This is conducted by interviewing, observing and touching a victim without further technical assistance. The Special Rapporteur finds that if there is a need for complementary tests, photographic documentation of the injuries at different stages, as well as X-ray analysis of wounded areas, will cover documentation of the majority of cases. Blood analysis, especially for the detection of creatine phosphokinase (CPK), an enzyme expressed by various tissues and cell types that signals the destruction of muscle cells, is a good indi cator of physical torture in the period ranging from 24 to 120 hours immediately after it takes place. The Special Rapporteur notes that those scientific tests are available in almost all countries and are not expensive. 42. In certain selected cases it can be necessary to conduct a computerized tomography (CT)-scan if there have been head concussions or other internal injuries. However, a thorough neurological examination can be sufficient and body CT-scans are only necessary in very severe cases and in connection with intensive care or with autopsies. CT-scanning is also available in most countries and not very costly. The only test that might not be available in some countries is electromyography (EMG), to diagnose neurological damage in the peripheral nervous system (e.g., paralysis secondary to trauma). The Special Rapporteur notes that this test is also not expensive, but it requires a neurologist or neurophysiologist to conduct and interpret the results. Properly trained personnel may be in short supply. Finally, bone scintigraphy (bone-scan), a modified X-ray test for the diagnosis of fractures that are invisible in traditional X -ray images, requires the injection of contrast in the wounded bone. This test is indicated almost exclusively in the case of the torture method known as “falanga” 21 and is neither difficult to __________________ 21 12/23 A form of corporal punishment in which the soles (specifically the arches) of a person’s bare feet are repetitively beaten with an implement. 14-61535