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.