Frequency of bone lesions: an inadequate criterion for gunshot wound diagnosis in skeletal remains

A retrospective study was carried out on 130 fatalities due to gunshot wounds to determine whether the combined absence of bone damage and projectile in a skeleton is sufficient to eliminate a diagnosis of gunshot wound. Our findings showed that bone lesions were present in about 90% of the cases and were associated with intracorporeal projectile(s) in about 70% of the cases. The presence or absence of bone lesions seemed independent of the gun characteristics, the shot conditions, and the type of death. The cause of death was predominantly brain injury in cases with bone lesions whereas thoracic, abdominal, and peripheral vascular causes were more frequently encountered in cases without bone damage. We concluded that the combined absence of bone lesions and intracorporeal projectile (about 5% in our series) cannot exclude a diagnosis of death secondary to gunshot wounds.