Paediatric radiologists are uniquely trained to interpret imaging in neonates, infants, children and adolescents. Their opinions assist courts in establishing the nature, timing and cause of injuries or disease, safeguarding scientific integrity while remaining strictly independent. Although their core analytical skills are identical, the emphasis of testimony and procedural framework differs across the Family, Criminal, Civil and Coroners jurisdictions.

Family Court

Most instructions arise in care proceedings, private‑law contact disputes or adoption cases. Radiologists scrutinise skeletal surveys, CT/MRI head scans and abdominal imaging to distinguish accidental trauma from non‑accidental injury (NAI) and to estimate fracture age. They may identify underlying conditions—osteogenesis imperfecta, rickets, bleeding diatheses—that mimic abuse. Evidence is usually given as a Single Joint Expert (SJE); permission requires a clear letter of instruction setting out specific questions. Reports must be child‑focused, explain methodology, state limitations and balance competing hypotheses. Attendance at experts’ meetings and the IRH is common; courtroom cross‑examination tests whether conclusions remain within radiological expertise and comply with the welfare checklist.

Criminal Court

In prosecutions for shaken‑baby syndrome, assault or homicide paediatric radiologists provide objective interpretation of injury patterns, timing of bleeds, and compatibility with alleged mechanisms. They explain radiographic features such as subdural haemorrhage, retinal haemorrhage on MRI, periosteal reaction and classic metaphyseal lesions. Reports must include qualifications, materials considered, technical parameters and a balanced discussion of alternative explanations. Oral evidence is delivered to the jury in plain English, often accompanied by annotated exhibits. Counsel will probe margin of error, published research and inter‑observer variability; radiologists must reference peer‑reviewed literature and adhere to CPS disclosure guidelines.

Civil Court

Civil instructions usually concern clinical negligence or personal‑injury litigation. Radiologists assess whether imaging findings were missed, mis‑interpreted or reported late; quantify residual disability; and comment on causation (e.g., obstetric trauma visible on neonatal MRI). Proportionality governs court permission: the report must be reasonably required to resolve the dispute. Experts may act jointly or for each side; concurrent evidence (“hot‑tubbing”) is increasingly mandated. Solicitors should provide full DICOM data, prior reports and guidelines extant at the material time. Clear articulation of the standard of care, Bolam/Bolitho tests and avoid legal conclusions (“negligence”) are essential.

Coroners Court

At inquests radiologists help establish medical cause of death, clarifying ante‑mortem or post‑mortem imaging, especially in sudden unexplained infant death (SUID) or suspected maltreatment. They may demonstrate chronic injury patterns consistent with earlier abuse or medical conditions contributing to mortality. Evidence is inquisitorial, not adversarial; opinions must be confined to radiological findings without attributing blame. Solicitors representing interested persons should supply autopsy imaging, histology summaries and clinical timelines well in advance.

Best‑practice tips for instructing solicitors

• Obtain court permission early and frame focused questions.
• Supply complete imaging datasets, chain‑of‑evidence logs and relevant clinical notes.
• Clarify deadlines for draft, final report, joint statement and attendance.
• Request a concise glossary for lay readers and ensure images are anonymised.
• Verify the expert carries adequate professional indemnity and is GMC revalidated with sub‑specialty registration.

Deliverables

A compliant report will:

• State instructions, materials, methodology and findings
• Differentiate fact from inference
• Reference current literature and diagnostic criteria
• Identify uncertainties
• Include the appropriate court‑specific declaration. By adhering to these standards paediatric radiologists offer robust, neutral evidence that assists all four jurisdictions in securing just, child‑centred outcomes.