Evaluation of Diagnostic Discrepancies in Nasal Bone Fractures at Public Hospitals in East Tehran According to Forensic Experts’ Opinions (2018–2019)

Nasal bone fractures are among the most prevalent indications for referral to forensic medicine centers for examination and certification. The objective of this study was to ascertain the frequency of diagnostic discrepancies in nasal bone fractures between public hospitals and forensic medicine experts in East Tehran zfrom 2018 to 2019. In this prospective quantitative study, 200 patients referred to the East Tehran Forensic Medicine Center in 2018 were selected based on available files. A survey was conducted to assess the frequency of unconfirmed nasal fracture diagnoses from public hospitals. These diagnoses were then analyzed in conjunction with the opinions of forensic experts. The results indicated that fractures were not confirmed in 59 patients (29.5%), suggesting a substantial discrepancy ( p < .05). The underlying causes for non-confirmation included an initial diagnosis that was either incorrect or missing (55.9%), the presence of old fractures (35.6%), and post-rhinoplasty conditions (8.5%). The study’s findings indicate that approximately one-third of nasal bone fracture diagnoses from public hospitals were not in accordance with the evaluations of forensic experts. The primary etiologies of these discrepancies were identified as diagnostic errors, pre-existing fractures, and post-surgical alterations. To address these concerns, it is advisable to place greater emphasis on the following: (a) the utilization of early and precise radiographic imaging, (b) comprehensive clinical documentation, and (c) the prompt referral of patients to forensic centers for expert evaluation.