Annalisa Cappella

The difficult task of assessing perimortem and postmortem fractures on the skeleton: a blind text on 210 fractures of known origin.

The distinction between perimortem and postmortem fractures is an important challenge for forensic anthropology. Such a crucial task is presently based on macro‐morphological criteria widely accepted in the scientific community. However, several limits affect these parameters which have not yet been investigated thoroughly. This study aims at highlighting the pitfalls and errors in evaluating perimortem or postmortem fractures. Two trained forensic anthropologists were asked to classify 210 fractures of known origin in four skeletons (three victims of blunt force trauma and one natural death) as perimortem, postmortem, or dubious, twice in 6 months in order to assess intraobserver error also. Results show large errors, ranging from 14.8 to 37% for perimortem fractures and from 5.5 to 14.8% for postmortem ones; more than 80% of errors concerned trabecular bone. This supports the need for more objective and reliable criteria for a correct assessment of peri‐ and postmortem bone fractures.

An osteological revisitation of autopsies: comparing anthropological findings on exhumed skeletons to their respective autopsy reports in seven cases.

Forensic anthropologists and pathologists are more and more requested to answer questions on bone trauma. However limitations still exist concerning the proper interpretation of bone fractures and bone lesions in general. Access to known skeletal populations which derive from cadavers (victims of violent deaths) who underwent autopsy and whose autopsy reports are available are obvious sources of information on what happens to bone trauma when subjected to taphonomic variables, such as burial, decomposition, postmortem chemical and mechanical insults; such skeletal collections are still however quite rare. This study presents the results of the comparative analysis between the autopsy findings on seven cadavers (six of which victims of blunt, sharp or gunshot wounds) and those of the anthropological assessment performed 20 years later on the exhumed dry bones (part of the Milano skeletal collection). The investigation allowed us to verify how perimortem sharp, blunt and gunshot lesions appear after a long inhumation period, whether they are still recognizable, and how many lesions are no longer detectable or were not detectable at all compared to the autopsy report. It also underlines the importance of creating skeletal collections with known information on cause of death and trauma.

The comparative performance of PMI estimation in skeletal remains by three methods (C-14, luminol test and OHI): analysis of 20 cases

When estimating post-mortem interval (PMI) in forensic anthropology, the only method able to give an unambiguous result is the analysis of C-14, although the procedure is expensive. Other methods, such as luminol tests and histological analysis, can be performed as preliminary investigations and may allow the operators to gain a preliminary indication concerning PMI, but they lack scientific verification, although luminol testing has been somewhat more accredited in the past few years. Such methods in fact may provide some help as they are inexpensive and can give a fast response, especially in the phase of preliminary investigations. In this study, 20 court cases of human skeletonized remains were dated by the C-14 method. For two cases, results were chronologically set after the 1950s; for one case, the analysis was not possible technically. The remaining 17 cases showed an archaeological or historical collocation. The same bone samples were also screened with histological examination and with the luminol test. Results showed that only four cases gave a positivity to luminol and a high Oxford Histology Index (OHI) score at the same time: among these, two cases were dated as recent by the radiocarbon analysis. Thus, only two false-positive results were given by the combination of these methods and no false negatives. Thus, the combination of two qualitative methods (luminol test and microscopic analysis) may represent a promising solution to cases where many fragments need to be quickly tested.

Dismemberment and disarticulation: A forensic anthropological approach.

The dismemberment of a corpse is fairly rare in forensic medicine. It is usually performed with different types of sharp tools and used as a method of concealing the body and thus erasing proof of murder. In this context, the disarticulation of body parts is an even rarer event. The authors present the analysis of six dismemberment cases (well-preserved corpses or skeletonized remains with clear signs of dismemberment), arising from different contexts and in which different types of sharp tools were used. Two cases in particular showed peculiar features where separation of the forearms and limbs from the rest of the body was performed not by cutting through bones but through a meticulous disarticulation. The importance of a thorough anthropological investigation is thus highlighted, since it provides crucial information on the manner of dismemberment/disarticulation, the types of tools used and the general context in which the crime was perpetrated.

The Issue of Age Estimation in a Modern Skeletal Population: Are Even the More Modern Current Aging Methods Satisfactory for the Elderly?†,‡

The main idea behind age assessment in adults is related to the analysis of the physiological degeneration of particular skeletal structures with age. The main issues with these procedures are due to the fact that they have not been tested on different modern populations and in different taphonomic contexts and that they tend to underestimate the age of older individuals. The purpose of this study was to test the applicability and the reliability of these methods on a contemporary population of skeletal remains of 145 elderly individuals of known sex and age. The results show that, due to taphonomic influences, some skeletal sites showed a lower survival. Therefore, the methods with the highest percentage of applicability were Lovejoy (89.6%) and Rougé‐Maillart (81.3%), followed by Suchey‐Brooks (59.3%), and those with the lowest percentage of applicability were Beauthier (26.2%) and Iscan (22.7%). In addition, this research has shown how for older adults the study of both acetabulum and auricular surface may be more reliable for aging. This is also in accordance with the fact that auricular surface and the acetabulum are the areas more frequently surviving taphonomic insult.

The application of cone-beam CT in the aging of bone calluses: a new perspective?

In the forensic and anthropological fields, the assessment of the age of a bone callus can be crucial for a correct analysis of injuries in the skeleton. To our knowledge, the studies which have focused on this topic are mainly clinical and still leave much to be desired for forensic purposes, particularly in looking for better methods for aging calluses in view of criminalistic applications. This study aims at evaluating the aid cone-beam CT can give in the investigation of the inner structure of fractures and calluses, thus acquiring a better knowledge of the process of bone remodeling. A total of 13 fractures (three without callus formation and ten with visible callus) of known age from cadavers were subjected to radiological investigations with digital radiography (DR) (conventional radiography) and cone-beam CT with the major aim of investigating the differences between DR and tomographic images when studying the inner and outer structures of bone healing. Results showed how with cone-beam CT the structure of the callus is clearly visible with higher specificity and definition and much more information on mineralization in different sections and planes. These results could lay the foundation for new perspectives on bone callus evaluation and aging with cone-beam CT, a user-friendly and skillful technique which in some instances can also be used extensively on the living (e.g., in cases of child abuse) with reduced exposition to radiation.

Thermal modifications of root transparency and implications for aging: a pilot study.

Root transparency has proven to be related to age and has been considered by different odontological methods for age estimation. Very little is known concerning possible variations of root transparency with heat, although the applicability of the method to burnt remains depends on the possible modifications of this specific variable. This pilot study presents the results of an experiment performed on 105 teeth obtained from dental patients and autopsy material, heated in an industrial oven at 50°C, 100°C, 150°C and 200°C. Root transparency was measured before and after the charring experiment. The heating process proved to radically modify root transparency, which decreased in 20% of samples at 50°C, in 34.6% at 100°C, in 50% at 150°C, in 77% at 200°C. The overall correlation index (CI) between decrease in root transparency and increase in temperature amounted to 0.96. These results show that heat may modify root transparency and suggest caution in using methods based on root transparency for age estimation.

The Difficult Task of Diagnosing Prostate Cancer Metastases on Dry Bone

The interpretation of pathology on skeletal remains is mandatory for implementing the biological profile and for disease recognition. Prostate cancer is one of the most common tumors, with a high preference for the skeleton as a primary site of metastasis. Its diagnosis on bone is however still ambiguous, due to its “osteoblastic” and resorptive manifestation. This study investigates distribution and appearance of prostate cancer metastases on dry bone on six known cases (selected from the Milano Cemetery Skeletal Collection) and one healthy individual. A macroscopic inspection was performed highlighting the abnormalities observed, describing location, shape, dimension, and aspect. A great amount of proliferative and mixed lesions was noticed, but also cases of pure lytic lesions were displayed. The multiple appearances of the manifestations observed display the difficulty in correctly identifying such a pathology, but also the potential and advantages provided by investigating a study sample with known antemortem history.

Survival of Atherosclerotic Calcifications in Skeletonized Material: Forensic and Pathological Implications

Atherosclerosis is a chronic inflammatory disease creating calcifying plaques in the arterial walls. Because its paleopathological diagnosis remains little studied on skeletal remains, its impact on forensic and archeological data is completely underestimated. Here, 24 skeletal remains from the Milano Cemetery Skeletal Collection have been studied to evaluate the chance of atherosclerotic calcification survival, retrieval, and identification. Through direct comparison with a known autopsy collection and literature, the identification and categorization of several types of calcifications were performed. Clothing elements such as tights or socks played a definitive role in the preservation of the calcifications; hence they are more likely to be found in forensic cases than in archeological ones. Therefore, vascular calcifications are possible to collect and identify in skeletal remains if sufficient care is given to their recovery. Consequently and as markers of the disease, such identification can provide valuable pathological information for forensic and archeological cases.

A modern documented Italian identified skeletal collection of 2127 skeletons: the CAL Milano Cemetery Skeletal Collection

The CAL Milano Cemetery Skeletal Collection is a modern and continuously growing identified osteological collection of 2127 skeletons under study in the Laboratorio di Antropologia e Odontologia Forense (LABANOF) in the Department of Biomedical Sciences for Health of the University of Milan (Italy), and part of the Collezione Antropologica LABANOF (CAL). The collection presents individuals of both sexes and of all age groups with a high representation of the elderly and an interesting sample of infants. Each individual is associated with a documentation that includes sex, age-at-death, dates of birth and death, and a death certificate that specifies the exact cause of death and the chain of events that led to it (related pathological conditions or traumatic events). It was also possible to recover for several individuals the autopsy reports and antemortem photographs. This documented osteological collection is of crucial interest in physical and forensic anthropology: it provides unique teaching opportunities and more importantly considerable research possibilities to test and develop sex and age estimation methods, investigate key subjects of forensic relevance and discuss pathological markers, among others. The aim of this paper is to introduce the CAL Milano Cemetery Skeletal Collection as a new identified skeletal collection and present its research and teaching potential.