Reading:: Detection of Antemortem Wounds on Dry Bones

The Detection of Microscopic Markers of Hemorrhaging and

Wound Age on Dry Bone: A Pilot Study

By Cristina Cattaneo, PhD, MD, Salvatore Andreola, MD, Eloisa Marinelli, MD, Pasquale Poppa, BSc, Davide Porta, BSc, and Marco Grandi, MD

It is easy for forensic pathologists to determine the survival time (time in between incident and death) of an injury largely by the color of the person’s skin—whether pink, reddish purple, blue, brown, yellow, etcetera. Each color represents a different stage of the healing process. This process ceases once the individual loses his/her life. For a short period of time, what you have left of the wound after death is a “snapshot” of the furthest stage of healing that was reached. For a forensic anthropologist working with dry bone versus fresh flesh, trying to make the same assumptions about injury survival time can be more labor-intensive. This is why the authors of this article conducted a pilot study of the evidences of trauma left on dry bone at varying survival interval rates. They used several cadavers to which the trauma survival time was known and conducted comparative analysis of the skeletal remains.

Methods

Fractured bones from 6 autopsies were collected from the Institute of Legal Medicine of Milano.

Case #	Bone Fractured	Survival Time
1	Rib	19 days
2	Tibia	34 minutes
3	Cranium	26 days
4	Cranium	16 days
5	Cranium	5 days
6	Rib	8.5 hours + negative control

A negative control fracture was created postmortem on the rib in case #6 to use for comparison. The bones were then artificially peutrified to remove all soft tissue. Next the specimens were viewed under a stereo microscope with special attention to the edges of the fractures to identify an periosteal (healing) reaction. The bones were then placed in 10% formalin and stained and decalcified. After decalcification, the bone was cut into 5mm blocks.

Results

Macroscopic review revealed that all but one of the bones showed no detectible macroscopic variation, which, anthropologically speaking means that the injuries would be ruled perimortem. Microscopic review, however, provided a great deal of more detail of the time of the injuries.

Case #	Survival Time	Microscopic Results
3	26 days	Blood clots suggestive of fibrin deposits
1	19 days	Foci of new bone formation
4	16 days	Blood clots suggestive of fibrin deposits
5	5 days	Deposition of fibrin
6	8.5 hours	Some deposition of fibrin
2	34 minutes	Slight blood clot

The results show the bones in different stages of healing corresponding to the survival time. This microscopic analysis supplied a great deal more information than the standard macroscopic procedure, which only ruled the fractures as ‘perimortem.’ So, histopathological research has proven by this study to be a worthy avenue to help forensic anthropologists determine traumatic survival time solely from dry bone. Such information can prove to have great forensic value in a death investigation. Of course, many more studies will need to be carried out experimenting with varying factors such as environment, individual healing rates, etcetera, before any scientific standards can be established. This is the very first study of its kind and it has opened the playing field for histopathological research on putrefied or macerated bone.

Source:

Cristina Cattaneo, PhD, MD, Salvatore Andreola, MD, Eloisa Marinelli, MD, 

        Pasquale Poppa, BSc, Davide Porta, BSc, and Marco Grandi, MD (2010), 

        The Detection of Microscopic Markers of Hemorrhaging and Wound Age 

        on Dry Bone: A Pilot Study, Am J Forensic Med Pathol • Volume 31, 

        Number 1.

Reading:: Ossifications!

Heterotopic Ossification in Unidentified Skeletal Remains

By Vincent J. M. DiMaio, M.D., & Jeffrey R. Francis, M.A.

Today I read an interesting case study about how ossifications on the bones of unidentified bodies can offer a great deal of valuable information concerning a person’s previous behavior and provide unique markers to the end of a positive identification. The authors discuss the highlighted case from an anthropological perspective. Not just what was found pertaining to the bones but how the information is useful for identification.

This is a case study of a 50-60 year old man whose skeleton was discovered buried in a shallow grave in a wooded area. The main type of pathology found on his skeleton is exostosis, which is a lump(s) that present on a bone most commonly as a result of inflammation or repeated trauma. Exostosis was found on the body and crest of the ilium. He has a broken left tibia with evidence of healing and fusion with the fibula. After his body was discovered, the police department called investigators’ attention to an orthopedics patient at a local veteran’s hospital who was discharged but never returned for his follow-up appointment. Since then his family had reported him missing. This patient was a paraplegic who previously had reconstructive back surgery. His medical history report was sent to the medical examiner and comparisons were made between the unknown’s radiographs and those from the patient’s medical report. It was a positive match. As it turns out he had been seriously injured in a motor vehicle accident and fractured his lower thoracic vertebrae. According to the hospital’s records he had not been keeping up to date with his physical therapy sessions and heterotopic bone growths were documented in the areas that correspond with the initial medical examiner’s report on the body.

The investigation also revealed that the man had left the hospital with another patient and they both had planned to leave the state together. One year and a half later the body of the patient he left with was discovered also in a shallow grave but was found 130 miles from the hospital. His manner of death was also ruled a homicide.

Heterotopic ossifications can be extremely helpful in cases of unidentified persons. The location of the muscle groups affected by the ossifications in an unidentified victim can be a good indicator of what types of stresses or actions may have caused the formation. For example, professional horseback riders often present with ossifications on the thigh adductors. Hunters or people who shoot high-powered rifles on a regular basis sometimes have ossifications surrounding the deltoid tuberosity of the humerus. Heterotopic ossifications found on the anterior pelvis and proximal femur are indicative of spinal chord injury and paraplegia.

The study concludes by reiterating the point that heterotopic ossifications are useful indicators of information to help create a biological profile for ‘Jane’ and ‘John Doe’s. According to the authors ittle has been taught about the causes of these ossifications so the information that the authors presented in this article can be informative even for practicing professionals.

Source:

Vincent J. M. DiMaio, M.D., & Jeffrey R. Francis, M.A. (2001), Heterotopic Ossification in Unidentified Skeletal Remains, The American Journal of Forensic Medicine andPathology 22(2):pp. 160–164.

Reading:: Identifying Cemetery Remains in Greece

Guidelines for the Recognition of Cemetery Remains in Greece

By Constantine Eliopoulos, PhD, Konstantinos Moraitis, PhD,Þ Federico Reyes, PhD, Chara  Spiliopoulou, MD, PhD, & Sotiris Manolis, PhD

As the authors state in the beginning of this article one of their main ideas behind this publication is to help conserve time and investigative resources by helping forensic anthropologists identify cemetery remains as early as possible, thus eliminating the need for unnecessary forensic investigation. All archaeological burials are not always obviously identified as such due to decomposition of the bodies along with any associated coffins or grave goods. Previous studies done in North America show that embalming is and has been a widespread tradition for cemetery burials; therefore, here unusually well-preserved bodies (among other signs) is usually indicative of the location of a cemetery. However, when excavations take place in countries where embalming is not commonly practiced it can be difficult to tell whether or not the human remains were buried in a cemetery. As a result investigators often waste their time and resources investigating the deaths of individuals that have no forensic significance. This article explains some common markers that have been identified in Greek burials through a study of human remains in Greece by the Department of Forensic Medicine & Toxicology of the University of Athens.

In order to begin identifying the origin of human skeletons one must first understand the burial practices of the contextual culture. In Greece embalming is only practiced on individuals who must be transported to another country and those who were prominent figures in society (there is a 2-3 day viewing period for the public in the church before burial). All individuals are buried with their heads toward the west.  There are also very few permanent cemeteries---most bodies are exhumed after a period of 3-5 years and placed in metal boxes to make room for new bodies to be buried. The boxes are stored in buildings called ossuaries. After a designated number of years in the ossuary the bodies are then disposed of in underground pits located within the cemetery or on non-residential, secluded areas of land. Some of the unidentified bodies are given to medical students for academic purposes. Yet another avenue of distribution is to be stolen by members of society for their use in playing practical jokes.

According to the authors the condition of the body itself offers the most information for identification of cemetery remains. If the body has been used for academic purposes they bones will often be bleached white and they may have wires stringing them together. Bones that were buried in a coffin often have what is referred to as ‘coffin wear,’ which is the erosion of pressure points of the skeleton like spinous process of vertebrae and the heads of the femur and humerus, among others. Coffin burials can also be identified by pieces of oak, chestnut or walnut wood found around the body. Also cut marks on the skull, ribs, sternum and claviculae can indicate the performance of an autopsy. Finally, if the bones were used for a practical joke they will often have wax, paint or glue traces on their surfaces.

In conclusion, it is of utmost importance for forensic anthropologists to become familiar with the funerary customs of the society in which excavations take place as customs vary widely between and within different countries. The authors of this article hope to offer information that can be used by forensic anthropologists to identify cemetery remains that are excavated within the contexts of cultures in which such identifications may be difficult, to the end of saving key investigative resources.

Source:

Constantine Eliopoulos, PhD, Konstantinos Moraitis, PhD,Þ Federico Reyes, PhD,
      Chara  Spiliopoulou, MD, PhD, & Sotiris Manolis, PhD (2011). Guidelines for
      the Recognition of Cemetery Remains in Greece, American Journal of 
      Forensic Medicine & Pathology Volume 32, Number 2, pp. 153-156.

Reading:: 6th-7th Century Cemetery Discovered in Italy

DNA Extraction: An Anthropologic Aspect of Bone Remains From Sixth- to Seventh-Century AD Bone Remains

By Nunzio Di Nunno, MD, PhD, Sandro Sublimi Saponetti, BSc, Vito Scattarella, BSc, Patrizia Emanuel, BSc, Stefania Lonero Baldassarra, BSc, Giuliano Volpe, BSc, and Cosimo Di Nunno, MD

This article reports the pathological data obtained from five individuals discovered within a 6^th or 7^th century cemetery, in addition to the results of a DNA comparison between the test population and a modern population native to the area. The site discussed in the article is located in Canosa di Puglia, which is in southern Italy and just southeast of Rome. During excavation of the early Christian Episcopal complex of Saint Peterfamily several tombs were uncovered and the authors of this article studied five individuals from three separate tombs. DNA analysis was performed on the selected subjects from the cemetery and compared against the Apulian population in search of genotypic differences and similarities. As it turned out, many of the alleles of the cemetery population did not even exist in the modern Apulian population. These findings are supported by the historical fact that in the Middle Ages there was a large amount of gene flow from Asian and Germanic people, thus diluting their native gene pools. This article presents the pathological data from an anthropological standpoint. Just from studying skeletal indicators, an anthropologist can infer information about an individual’s health (or lack thereof), living conditions, past traumatic events, diet, daily activities as well as cause of death. I will briefly describe the five individuals discussed in the article.

Individual 28A: A 40-43 year-old male whose stature is estimated at 170 centimeters (almost 5’-7”) with a very robust frame.  A dental examination presented moderate tooth wear, severe periodontosis, two odontogenic abcesses, but no cavities. There was also apparent significant weight overload of the cervical vertebrae. Alteration to the clavicular/acromial region indicates past shoulder dislocation. Phlogosis of the os zygomaticum was present also.

28E: Male between the ages of 44 and 60 years old. He stood approximately 177 centimeters (about 5’-8”) tall. He had several lines of hypoplaysia on his tooth enamel that were formed between 1 and 6 years of age. He also exhibited weight overload in the vertebral index. Osteoarthrosis (lipping and pitting) is present along with other musculoskeletal markers that suggest a great deal of muscular activity.

29B: Female approximately 50—65 years of age and about 159 centimeters (approx. 5’-2”). Her vertebrae did not show any evidence of weight overload, unlike the previous two males, neither was there any evidence of extreme muscular activity.

29E: Male of 45 years of age at time of death. His height was about 169 centimeters (approx. 5’-6”). An examination of his teeth reported mild dental wear, two cavities, an abscess, and an unusual amount of tartar. His cervical tract showed moderate weight load and pronounced tendon impressions, which could have been caused by extreme muscular activity. This individual also showed evidence of osteoarthrosis in the forms of moderate lipping and pitting, but no eburnation.

31A: Male subject of about 54 years of age. He is estimated to be 179 centimeters tall (about 5’-9”). A dental examination yielded the following results: two cavities, an abscess, lines of hypoplaysia, moderate tooth wear and severe periodontitis. There was evidence of a moderate weight load in the cervical region and a weight overload in the thoracolumbar region.

The authors come to the conclusion that the alterations found associated with the skull, vertebrae, long bones and ribs are attributable to inflammatory foci and are likely of tubercular origin.

Source:

DNA Extraction: An Anthropologic Aspect of Bone Remains From Sixth- to Seventh-Century AD Bone Remains (2007) Nunzio Di Nunno, MD, PhD, Sandro Sublimi Saponetti, BSc, Vito Scattarella, BSc, Patrizia Emanuel, BSc, Stefania Lonero Baldassarra, BSc, Giuliano Volpe, BSc, and Cosimo Di Nunno, MD, American Journal of Forensic Medicine & Pathology 2007;28: 333–341.