Sharp penetrating wounds: spectrum of imaging findings and legal aspects in the emergency setting

The main cause of severe civilian trauma is not the same all over the world; while in Europe the majority of cases are due to blunt traumatic injury, in the United States, penetrating gunshot wounds are the most common. Penetrating wounds can be classified into two different entities: gunshot wounds, or more technically ballistic traumas, and sharp penetrating traumas, also identifiable with non-ballistic traumas. Sharp penetrating injuries are mainly caused by sharp pointed objects such as spears, nails, daggers, knives, and arrows. The type of injuries caused by sharp pointed objects depends on the nature and shape of the weapon, the amount of energy in the weapon or implement when it strikes the body, whether it is inflicted upon a moving or a still body, and the nature of the tissue injured. In the assessment of hemodynamically stable patients with sharp penetrating wounds, the main imaging procedure is Multidetector Computed Tomography (MDCT), especially used in complicated cases of penetrating injuries with an important impact on the final therapeutic choice. The diagnostic approach has been changed by MDCT due to its technical improvements, in particular, faster data acquiring and upgraded image reconstructions.