An Analysis of Human Skeletal Remains with Cerebral Palsy: Associated Skeletal Age Delay and Dental Pathologies*

Abstract: In 2002 the authors were asked to examine the skeletal remains of an individual with a known history of severe cerebral palsy (CP) who was 21–23 years old at death. Skeletal age estimates of 11–15 years and dental age estimates of c. 16 years are younger than the known age of the decedent. Skeletal analysis also identified dental pathologies such as chronic tooth grinding and substantial calculus deposits. Scarce literature exists on forensic human remains cases with CP, and this study contrasts the age discrepancy and other features of this case with typical clinical characteristics of CP. A review of the CP literature suggests that delayed skeletal maturation and dental pathologies such as those observed in this case are indicative of complications related to CP. This article may alert future investigators to some of the osteological signs of CP and the probability that age indicators may be misleading.     

Recognition of Skeletal Fractures in Infants: An Autopsy Technique

Abstract:  Complete recognition and documentation of injury pattern is crucial in the diagnosis of child abuse. Skeletal fractures regarded as highly specific to nonaccidental injury in infants include posterior rib, scapular, metaphyseal, and spinous process fractures. These injuries are often occult, especially when acute, to standard radiologic and autopsy procedures. The presented autopsy technique requires incising and reflecting skeletal muscles to expose the bones and costal osseous joints in situ , increasing the opportunity to recognize skeletal injury. Fractured or atypical appearing bones are removed and processed for complete evaluation. The bones are processed by macerating the soft tissue in a water soap bath at an elevated temperature. To aid in reconstruction of the decedent, long bones are replaced with wooden dowels and the chest cavity is packed with the organ bag. The technique is invasive and recommended for cases in which the pathologist has reasonable suspicion of acute or remote trauma.     

Skeletal identification by radiographic comparison: blind tests of a morphoscopic method using antemortem chest radiographs

This study investigated the value of antemortem (AM) and postmortem (PM) radiographs of the claviculae and C3-T4 vertebrae to identify skeletons of missing U.S. soldiers from past military operations. In total, 12 field-recovered skeletons and AM chest radiographs of 1460 individuals were used. For each skeleton, examiners analyzed an array of AM chest radiographs (up to 1000 individuals) and attempted to identify the correct PM/AM radiographic match. When examiners were able to compare all images within a single test, only true-positive identifications were made. When AM radiographs were presented one-at-a-time, in sequential order, and without examiners having knowledge of array size, erroneous identifications resulted but they were almost exclusively made by untrained examiners (accuracy = 35% vs. 90% for trained examiners). This study demonstrates the value of chest radiographs for the identification of disarticulated and even eroded skeletons, but only when methods are wielded by trained examiners.     

A metric method for sex determination using the proximal femur and fragmentary hipbone

The pubic bone is considered one of the best sources of information for determining sex using skeletal remains, but can be easily damaged postmortem. This problem has led to the development of nonpelvic methods for cases when the pubic bone is too damaged for analysis. We approached this problem from a different perspective. In this article, we present an approach using new measurements and angles of the proximal femur to recreate the variation in the pubic bone. With a sample from the Terry Collection (n > 300), we use these new variables along with other traditional measurements of the femur and hipbone to develop two logistic regression equations (femur and fragmentary hipbone, and femur only) that are not population specific. Tests on an independent sample (Grant Collection; n = 37-40) with a different pattern of sexual dimorphism resulted in an allocation accuracy of 95-97% with minimal difference by sex.     

Indoor Wet Screening of Exhumed Skeletal Remains: A Suggested Procedure for the Preparation of Fragile Evidence for Anthropological Analysis

Abstract: The 2007 exhumation of three children’s graves, located in rural upstate New York and dating to 1979 and 1980, was warranted as their mother had come under suspicion for the death of a child she had been babysitting in late 2006. The local March weather conditions had been wet, and heavy rains fell during the 2‐day process of casket removal. The extremely wet soil and the poor preservation of two wooden caskets increased the likelihood of damage to evidence. After remains’ transport to the forensic center, an indoor wet‐screening station was established so that skeletal elements could be (i) separated from soil matrix and (ii) preserved carefully for analysis. Not only were the remains relatively small and fragile in comparison with those of an adult, but two of the three remains were known to be fire damaged, thus the use of special laboratory preparation techniques was crucial.     

Metric assessment of the "mastoid triangle" for sex determination: a validation study

Recently, a metric approach to skeletal sex determination was published by Paiva and Segre which is based on the summation of two triangular areas defined by three distinct craniometric landmarks: Porion, Mastoidale, and Asterion. According to the authors, values for the total triangle > or =1447.40 mm(2) are characteristic for male crania, while values < or =1260.36 mm(2) are indicative of female skulls (95% confidence). In order to evaluate the method's validity, two sex- and age-documented samples of different provenience were analyzed (N=197). The results show that while the indicated measurements display significant sex differences, the technique is of little practical meaning where a single individual must be independently classified. It is hypothesized that differences in the expression of sexual dimorphism as well as a population-specific variability of the asterion location undermine the value of the mastoid triangle as a sex determinant.     

Age estimation from the human os coxa: a test on a documented Italian collection*

Current standards for age at death estimation from the pelvis are based on Americans of European and African ancestry. Our limited understanding of population variability hampers our efforts to apply these techniques to the various skeletal populations around the world, especially in global forensic contexts. However, documented skeletal samples are rare, limiting our ability to test our techniques. This study tested the Suchey-Brooks pubic symphysis aging method and the auricular surface method originally developed by Lovejoy et al. on a large sample (n = 404) of known sex and age from the Sassari Collection, housed at the Museum of Anthropology at the University of Bologna, Italy. The results indicate that for both methods, bias and inaccuracy increased with age and actual age tended to be underestimated over the age of 40. The auricular surface method performed slightly better, exhibiting slightly lower levels of bias and inaccuracy, especially for males.     

Role of orthopedic implants and bone morphology in the identification of human remains

When conventional methods of identification, such as visual recognition and dental comparison, cannot be used to identify a deceased person, it becomes necessary to consider alternative methods. The presence of an orthopedic implant in a body may assist identification if ante-mortem medical records are available for comparison. Another method of identification involves comparison of ante-mortem and postmortem radiographs. Eight cases are reported from Forensic Science SA where the presence of orthopedic implants and/or ante-mortem radiographs were used to try to establish identification. In six cases, positive identification was established, and in two cases with upper limb orthopedic implants, the bones remained unidentified. Manufacturers were unable to provide any information about the distribution and use of the implants that could be of use with identification, as there are no requirements in Australia for individual medical implants to be tracked. Such a system has the potential to aid postmortem identification if serial codes were etched onto implants that could then be traced to manufacturers, surgeons, and recipients of these devices.     

Forensic Approach to an Archaeological Casework of “Vampire” Skeletal Remains in Venice: Odontological and Anthropological Prospectus*

Abstract: During the years 2006–2007, the Archeological Superintendent of Veneto (Italy) promoted a research project on mass graves located on Nuovo Lazzaretto in Venice, where the corpses of plague deaths were buried during the 16th and 17th centuries. The burials were of different stages and are believed to be the remains of plague victims from the numerous outbreaks of pestilence, which occurred between the 15th and 17th centuries. Among the fragmented and commingled human bones, an unusual burial was found. The body was laid supine, with the top half of the thorax intact, arms parallel to the rachis axis, the articulations were anatomically unaltered. Both the skull morphology and the dimensions of the caput omeris suggest the body was a woman. A brick of moderate size was found inside the oral cavity, keeping the mandible wide open. The data collected by the anthropologist were used to generate a taphonomic profile, which precluded the positioning of the brick being accidental. Likewise, the probability of the brick having come from the surrounding burial sediment was rejected, as the only other inclusions found were bone fragments from previous burials in the same area. The data collected by the odontologist were employed for age estimation and radiological dental assessment. The forensic profile was based conceptually on the “circumstances of death” and concluded that the positioning of the brick was intentional, and attributed to a symbolic burial ritual. This ritual confirms the intimate belief held at those times, between the plague and the mythological character of the vampire.     

Determining sex of the posterior ilium from the robert j. Terry and william m. Bass collections

Morphological traits of the posterior ilium are commonly used for sex determination in bioarcheological and forensic skeletal analysis. This study was designed to compare the classification correctness of standard scoring systems and measurements of the posterior ilium, including using logistic regression, to develop new formulae to predict sex. Metric measurements and morphological scores for the preauricular sulcus (PS), the elevation of the auricular surface, and the greater sciatic notch width were recorded for 97 males and 101 females of both European and African ancestry from the William M. Bass and Terry Collections. Correct classification of sex was high using individual traits such as the greater sciatic notch score (88.4%), the presence or absence of a PS (78.8%), and the scoring of a present PS as 1, 2, or 3 (100%). Furthermore, an equation combining multiple traits of the posterior ilium had a high classification of 94.9%.     

Stature estimation of 3-10-year-old children from long bone lengths

Estimation of stature in adult forensic cases with available long bones of the limbs is routine, but such estimation is less common in subadult cases. Long bones from subadult cases are often used to estimate age, but in some instances stature may be helpful or even critical for identification. Few published regression equations exist for consultation in such cases. Data from the longitudinal growth study conducted by the Child Research Council in Denver in the mid-1900s are utilized to produce dual-sex and single-sex regression equations for the six long bones of the limbs (humerus, radius, ulna, femur, tibia, and fibula) and for the combined femur+tibia length. All measurements are from radiographs and are of diaphyseal length. Examples show that similar results can be obtained using a two-step process of "ballpark" estimation from published tables of the Denver data, but these new regressions allow a one-step standard error estimate for the means. Regressions are further compared with those previously published by Finnish researchers, which are generally broadly comparable. More routine stature estimation in subadult cases is encouraged both as an aid to possible identification and as a test of the available regression equations.     

Sex estimation in forensic anthropology: skull versus postcranial elements

When the pelvis is unavailable, the skull is widely considered the second best indicator of sex. The goals of this research are to provide an objective hierarchy of sexing effectiveness of cranial and postcranial elements and to test the widespread notion that the skull is superior to postcranial bones. We constructed both univariate and multivariate discriminant models using data from the Forensic Anthropology Data Bank. Discriminating effectiveness was assessed by cross-validated classification, and in the case of multivariate models, Mahalanobis D(2). The results clearly indicate that most postcranial elements outperform the skull in estimating sex. It is possible to correctly sex 88-90% of individuals with joint size, up to 94% with multivariate models of the postcranial bones. The best models for the cranium do not exceed 90%. We conclude that postcranial elements are to be preferred to the cranium for estimating sex when the pelvis is unavailable.     

Structural analysis of human rib fracture and implications for forensic interpretation

Patterns of rib fractures are of significant clinical and forensic interest. Linking patterns of rib fracture with specific physical events provides a foundation for understanding the nature of traumatic events that are associated with rib fracture in forensic contexts. In this study, isolated human ribs (n = 8) were end-loaded to failure to investigate: (i) local deformations (bone strain) prior to and during structural failure, (ii) location of ultimate failure, and (iii) fracture mode. Structural properties of ribs were used to calculate theoretical stresses to determine whether such calculations could be used to predict site of fracture. Ribs fractured on the sternal side of midshaft in all experiments, but mode of failure varied with transverse, buckle, spiral, and "butterfly" fractures observed. Comparison of calculated stress with observed strain values suggest that experimental, rather than theoretical, approaches will be most productive in furthering understanding rib fracture in forensic contexts.     

Surgical Sutures as a Means of Identifying Human Remains*

Abstract: The Food and Drug Administration does not require surgical sutures to be tracked by manufacturer, physician, or patient; thereby, surgical sutures have been of little use to forensic practitioners who are tasked with establishing a positive identification with biological evidence. This study demonstrates the investigative process used to pinpoint suture manufacturers by presenting a case where surgical sutures were a distinctive characteristic that aided in the positive identification of skeletal remains. The suture’s manufacturer, construction material and structure, size, and medical use was determined by contacting a local surgical suture and orthopedic implant manufacturer and utilizing publicly available manufacturer websites, which provide catalogs and specific product details. This research was one of many lines of evidence used to establish the positive identification of a 47‐year‐old male.     

A Comparison of Histomorphometric Data Collection Methods*

Abstract: Although many variables that skeletal biologists examine have been standardized, the actual techniques used to collect these data from bone thin sections vary. This project compares different methods of obtaining data (relative cortical area values) for histomorphometric research. One visual and three digital methods of histomorphometric data collection are compared: (i) Merz microscopic eyepiece counting reticule, (ii) flatbed scanner, (iii) overlaying multiple images of a thin section, and (iv) digital SLR camera with macro settings. The discussion includes a comparison of usability factors such as cost, time, user‐experience, and ease‐of‐use, which vary for each method. Values from the different methods are compared using ANOVA tests to evaluate inter‐method, inter‐observer, and intra‐observer variability. Intra‐observer error was greater for the microscopic method, although the error values are concomitant with experience. We found no statistically significant differences between the four methods examined, but certain caveats must be addressed when these methods are used.     

Ossification of laryngeal structures as indicators of age

As the role of forensic anthropologists expands to the medical examiner setting, their expertise is being applied beyond the traditional dry skeletal material. In such scenarios radiographic techniques can be applied when maceration is not appropriate. This study explores the use of radiographic analysis of laryngeal structures for age-at-death determination. Isolated human laryngeal structures (n = 104) from individuals between the ages of 15 and 89 were removed at autopsy and radiographically examined. The cricoid and individual regions of the thyroid cartilage were scored according to degree of ossification, and the relationship between age and degree of ossification statistically examined. A previously published study on age-determination from thyroid ossification by Cerny was assessed for accuracy. The results of the study indicate that although a consistent sequence in the ossification of laryngeal structures exists, variations in timing does not permit narrow age range estimates. Consequently the method presented by Cerny is inaccurate and should not be used in the forensic setting.     

Anthropological and Radiographic Comparison of Antemortem Surgical Records for Identification of Skeletal Remains*

Abstract: This case review illustrates the important contributions of forensic archeological methods and forensic anthropological analysis to the identification of found skeletal remains. After reassociation of skeletal remains found in two locations, anthropological analysis provided the basis for a presumptive identification and a request for antemortem medical records. Partial DNA profiles were supportive but not conclusive and antemortem dental records were not available. Comparison of antemortem traumas, skeletal morphology, and surgical artifacts with antemortem radiographs and surgical records led to positive identification of an individual missing for almost a decade.     

Death in custody: a historical analysis

This research delineates the historical evolution of death in custody. A retrospective, exploratory analysis of 145,425 cases from Maryland's Office of the Chief Medical Examiner, occurring from 1939 to 2004, was conducted. Two hundred and two custodial deaths were identified and subsequently examined relative to time, agency, decedent characteristics, and cause and manner of death. Results indicate that there have been substantive changes in custodial deaths over time. Cardiovascular disease was the most frequent cause of death from the 1930s to the 1970s, except for the 1940s, when syphilis and tuberculosis took precedence. Asphyxia, the predominant cause of death in the 1980s, reflected an increase in suicidal hangings. Emerging in the 1980s, drug intoxication deaths were prevalent in the 1990s and 2000s. Sudden unexplained deaths involving violent behavior, the use of multiple restraints, and drug intoxication were not identified until the 1980s, coinciding with periods of increased cocaine abuse nationally.