Citation

Pasquale-Styles MA, Crowder CM, Fridie J, Milla SS. J. Forensic Sci. 2014; 59(6): 1668-1671.

Affiliation

Fulton County Medical Examiner Center, Atlanta, GA.

Copyright

(Copyright © 2014, American Society for Testing and Materials, Publisher John Wiley and Sons)

DOI

10.1111/1556-4029.12609

PMID

25382601

Abstract

Bilateral symmetric bone nodules were observed in the anterolateral first ribs of an infant with shaking injuries at autopsy. The location prompted diagnostic considerations of healing fractures versus anomalous articulations with pseudarthroses. The forensic pathologist worked with forensic anthropologists and pediatric radiologists to evaluate autopsy findings and compare premortem and postmortem X-rays. Gross examination of the bones by the pathologist and anthropologists confirmed bilateral, callus-like bone nodules in first-rib locations associated with pseudarthroses. Histologic examination of one of the bones further showed features most consistent with pseudarthrosis, not a healing fracture. Radiologists then compared multiple premortem and postmortem radiographs that showed no remodeling of the bone over a 2-week interval between the time of injury and death, which would be unexpected for a healing fracture in an infant. This multidisciplinary approach resulted in the appropriate diagnosis of pseudarthroses due to anomalous articulations, an uncommon finding in forensic pathology.

Language: en