The Contribution of Hybrid SPECT CT Imaging with [<sup>99m</sup>Tc] Tc-MDP in Battered Woman Syndrome

Introduction: Violence against women is a widespread health problem that knows no racial or social boundaries. It is generally difficult for forensic investigators to obtain medical evidence of violence, particularly in cases where the victims are assessed several months after the event. Bone scintigraphy can be used to identify and document trauma related to acts of torture, and it can also serve as valid evidence in court. Case report: The bone scan revealed multiple areas of tissue uptake in the early phase, associated with bone uptake in the late phase involving both the axial and peripheral skeleton. In addition, several areas of bone uptake were observed in the late phase without corresponding tissue uptake in the early phase. The scintigraphic pattern demonstrated that the patient's bone lesions were of different ages. Based on these findings, early tissue uptake associated with late bone uptake was consistent with recent post-traumatic lesions, whereas late bone uptake without early tissue uptake was consistent with old post-traumatic lesions. The distribution of certain skeletal lesions suggested a defensive posture adopted by the victim. Conclusion: In the context of a forensic investigation, bone scintigraphy is a valuable tool that not only detects bone lesions in patients suspected of physical assault, whether or not they present clinical signs, but also helps to determine when the injury occurred.