Gunshot wounds, depending on the velocity of the missile fired and the proximity of the weapon, cause a variable degree of superficial and penetrating injury, which may be life-threatening if major blood vessels or organs are affected. A careful clinical inspection of the entrance wound, determining if an exit wound is present, and appropriate imaging studies are necessary components in the diagnostic workup.
Gunshot wounds may encompass a broad range of injuries involving soft tissues, bones, blood vessels and other underlying structures, including vital organs . The extent of the injury and the appearance of the wound will depend on two factors: the velocity of the bullet or missile and the proximity of the weapon at the time of firing. Firstly, bullets are classified as low-velocity (with a speed of < 600 m/s) or high-velocity (> 600 m/s), and high-speed bullets which are more likely to cause deep penetrating injuries  . Secondly, studies have divided the appearance of a gunshot wound into four main categories, depending on the distance of the firearm to the body :
Immediate inspection of the wound and assessment of the presence of an exit wound is the first important step in the diagnostic workup and it is necessary for determining further care. The shape of the wound, its pattern, borders, as well as the presence (or absence) of soot are essential steps, while history taking (if possible from the patient or from accompanying persons) is equally important. After a full clinical workup, imaging studies in the form of plain radiography, computed tomography (CT) and ultrasonography need to be employed, in order to evaluate the extent of tissue injury, including the subcutaneous tissues, blood vessels, bones and vital organs    . Although some authors have concluded that the potential risks of using magnetic resonance imaging (MRI) as an imaging method are significantly outweighed by its potential benefits, physicians should be cautioned about performing MRI as metallic objects and bullets in the vicinity of important structures could get dislodged and cause secondary injuries  .