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.
Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy.
Int J Legal Med. 2019 Sep;133(5):1611-1628. doi: 10.1007/s00414-019-02122-0. Epub 2019 Jul 12.
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.
骨病变的诊断是骨骼遗骸研究的基本部分，无论是在考古学还是法医学背景下。一方面，文献证明了放射线照相术在检测骨病变方面的重要性；另一方面，对骨病变形态的仔细宏观观察往往被低估。在这项研究中，我们对 14 具被诊断患有类风湿性关节炎、糖尿病、多发性骨髓瘤、转移性癌症和佝偻病的米兰 CAL 公墓骨骼收藏的骨骼进行了检查和普通放射摄影，以比较骨病变的宏观形态和放射影像学表现。至少研究了 200 个溶骨性病变和 65 个增生性骨反应区（海绵骨硬化或骨膜）。我们制作了相同骨骼元素的宏观照片和放射成像的“对比集”，以允许对骨病变的检测和识别进行比较。结果表明，虽然通过肉眼观察可能会丢失小梁病变，但由于对比度，许多病变也可能在放射线照相术中无法察觉，包括骨膜反应、溶骨性病变和海绵骨硬化。这项研究的目的是调查数字放射摄影术和宏观分析的优缺点，并证明两种方法在干燥骨骼病变分析中的互补方法之间的协同作用。
