The synergy between radiographic and macroscopic observation of skeletal lesions on dry bone

International Journal of Legal Medicine volume 133, pages1611–1628(2019)Cite this article

Abstract

The diagnosis of bone lesions is a fundamental part of the study of skeletal remains, both in the archeological and forensic context. On the one side, the literature proved the relevance of radiography for the detection of bone lesions; on the other side, the careful macroscopic observation of the morphology of bone lesions is often underestimated. For this study, we examined and performed plain radiography on 14 skeletons of the CAL Milano Cemetery Skeletal Collection diagnosed with rheumatoid arthritis, diabetes, multiple myeloma, metastatic cancer, and osteomalacia to compare the macroscopic morphology and radiographic visualization of bone lesions. At least 200 osteolytic lesions and 65 areas of proliferative bone reaction (either spongiosclerotic or periosteal) were studied. We realized “comparative sets” of macroscopic pictures and radiographic imaging of the same skeletal elements to allow comparisons of detection and recognition of bone lesions. As a result, while trabecular lesions may be lost through naked eye observation, many lesions can also be unperceived on radiographs due to contrast, including periosteal reactions, osteolytic lesions, and spongiosclerosis. The aim of this research was to investigate the strengths and pitfalls of digital radiography and macroscopic analysis and to demonstrate the synergy of a complementary approach between the two methods for lesion analysis in dry bone.

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Affiliations

  1. Laboratorio Di Antropologia E Odontologia Forense (LABANOF), Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Via Mangiagalli 37, 20133, Milan, Italy

    Lucie Biehler-Gomez & Cristina Cattaneo

  2. Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy

    Stefania Tritella & Francesco Sardanelli

  3. Dipartimento di Medicina Sperimentale, Università degli Studi della Campania “Luigi Vanvitelli”, via Santa Maria di Costantinopoli 16, 80138, Naples, Italy

    Federica Martino & Carlo Pietro Campobasso

  4. Forensic Medicine Department, University Hospital of Lyon, Lyon, 69003, France

    Angélique Franchi

  5. Post-Graduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy

    Riccardo Spairani

  6. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy

    Francesco Sardanelli

Authors
  1. Lucie Biehler-Gomez
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  2. Stefania Tritella
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  3. Federica Martino
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  4. Carlo Pietro Campobasso
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  5. Angélique Franchi
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  7. Francesco Sardanelli
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  8. Cristina Cattaneo
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Correspondence to Lucie Biehler-Gomez.

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Biehler-Gomez, L., Tritella, S., Martino, F. et al. The synergy between radiographic and macroscopic observation of skeletal lesions on dry bone. Int J Legal Med 133, 1611–1628 (2019). https://doi.org/10.1007/s00414-019-02122-0

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Keywords

  • Forensic anthropology
  • Bone pathology
  • Radiographic imaging
  • Rheumatoid arthritis
  • Diabetes
  • Metastatic carcinoma