Skip to main content
SpringerLink
Log in

Thermal bone injuries: postmortem computed tomography findings in 25 cases

  • Original Article
  • Published:
International Journal of Legal Medicine Aims and scope Submit manuscript

Abstract

Introduction

Fire death investigations attempt to determine whether a subject was alive or dead before the fire started. Therefore, it is essential to assess if the bone damage is traumatic or the result of exposure to heat. This observational study aims to expose the specific CT semiology of thermal bone lesions to allow the forensic radiologist to identify and distinguish them from traumatic lesions that would have preceded death.

Materials and methods

We retrospectively reviewed the CT findings of 25 bodies with thermal bone lesions for which a postmortem computed tomography (PMCT) was performed prior to an autopsy. Imaging findings were correlated to the autopsy data to identify the specific features of thermal bone lesions.

Results

Specific signs of thermal injuries to bone were identified on PMCT on all deceased cases. Thermal damages predominated in areas directly exposed to flames (rib cage, distal extremities) with less soft tissue coverage (“soft tissue shielding”). The mottled appearance of bone marrow was a constant sign of burned bones. Heat fractures such as trans-diploic fractures of flat bones and beveled (“flute-mouthpiece”) fractures of extremities seemed specifically related to thermal mechanism. In addition, we provided a better description of superficial cortical fissures of flat bones (“ancient Chinese porcelain”) and observed a “stair step” fracture of a long bone until now undescribed in radiological literature.

Conclusion

Thermal bone lesions have specific CT findings, different on several points from traumatic injuries. Their knowledge is essential for radiologists and forensic physicians to provide an accurate report of injury and conclusions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Quatrehomme G, Beauthier J-P, Lefèvre P (2015) Traité d’anthropologie médico-légale

  2. Mata Tutor P, Benito Sánchez M, Villoria Rojas C, Muñoz García A, Pérez Guzmán I, Márquez-Grant N (2021) Cut or burnt? – categorizing morphological characteristics of heat-induced fractures and sharp force trauma. Leg Med 50:101868. https://doi.org/10.1016/j.legalmed.2021.101868

    Article  Google Scholar 

  3. Delabarde T, Ludes B (2014) Manuel pratique d’anthropologie médico-légale. Éd. Eska

  4. Thompson TJU (2005) Heat-induced dimensional changes in bone and their consequences for forensic anthropology. J Forensic Sci 50:1008–1015

    Article  CAS  Google Scholar 

  5. Schmidt CW, Symes SA (eds) (2015) The analysis of burned human remains, 2nd edn. Elsevier/Academic Press, Amsterdam; Boston

    Google Scholar 

  6. Herrmann NP, Bennett JL (1999) The differentiation of traumatic and heat-related fractures in burned bone. J Forensic Sci 44:461–469

    Article  CAS  Google Scholar 

  7. Ubelaker DH (2009) The forensic evaluation of burned skeletal remains: a synthesis. Forensic Sci Int 183:1–5. https://doi.org/10.1016/j.forsciint.2008.09.019

    Article  PubMed  Google Scholar 

  8. Pope EJ, Smith OC (2004) Identification of traumatic injury in burned cranial bone: an experimental approach. J Forensic Sci 49:431–440

    Article  Google Scholar 

  9. Grévin G (2011) Les os brûlés. Etude et identification. Traité de médecine Légale. 2ème édition. De Boeck

  10. Bohnert M, Rost T, Pollak S (1998) The degree of destruction of human bodies in relation to the duration of the fire. Forensic Sci Int 95:11–21. https://doi.org/10.1016/S0379-0738(98)00076-0

    Article  CAS  PubMed  Google Scholar 

  11. Willaume T, Farrugia A, Kieffer E-M, Charton J, Geraut A, Berthelon L et al (2018) The benefits and pitfalls of post-mortem computed tomography in forensic external examination: a retrospective study of 145 cases. Forensic Sci Int 286:70–80. https://doi.org/10.1016/j.forsciint.2018.02.030

    Article  PubMed  Google Scholar 

  12. Kasahara S, Makino Y, Hayakawa M, Yajima D, Ito H, Iwase H (2012) Diagnosable and non-diagnosable causes of death by postmortem computed tomography: a review of 339 forensic cases. Leg Med (Tokyo) 14:239–245. https://doi.org/10.1016/j.legalmed.2012.03.007

    Article  Google Scholar 

  13. Le Blanc-Louvry I, Thureau S, Duval C, Papin-Lefebvre F, Thiebot J, Dacher JN et al (2013) Post-mortem computed tomography compared to forensic autopsy findings: a French experience. Eur Radiol 23:1829–1835. https://doi.org/10.1007/s00330-013-2779-0

    Article  PubMed  Google Scholar 

  14. Norberti N, Tonelli P, Giaconi C, Nardi C, Focardi M, Nesi G et al (2019) State of the art in post-mortem computed tomography: a review of current literature. Virchows Arch 475:139–150. https://doi.org/10.1007/s00428-019-02562-4

    Article  PubMed  Google Scholar 

  15. Ampanozi G, Halbheer D, Ebert LC, Thali MJ, Held U (2020) Postmortem imaging findings and cause of death determination compared with autopsy: a systematic review of diagnostic test accuracy and meta-analysis. Int J Legal Med 134:321–337. https://doi.org/10.1007/s00414-019-02140-y

    Article  PubMed  Google Scholar 

  16. Del Fante Z, De Matteis A, Fazio V, Di Fazio N, Quattrocchi A, Romano S et al (2019) The importance of post mortem computed tomography (PMCT) in the reconstruction of the bullet trajectory. Clin Ter 170:e129–e133. https://doi.org/10.7417/CT.2019.2122

    Article  PubMed  Google Scholar 

  17. Legrand L, Delabarde T, Souillard-Scemama R, Sec I, Plu I, Laborie J-M et al (2020) Comparison between postmortem computed tomography and autopsy in the detection of traumatic head injuries. J Neuroradiol 47:5–12. https://doi.org/10.1016/j.neurad.2019.03.008

    Article  CAS  PubMed  Google Scholar 

  18. Grabherr S, Egger C, Vilarino R, Campana L, Jotterand M, Dedouit F (2017) Modern post-mortem imaging: an update on recent developments. Forensic Sci Res 2:52–64. https://doi.org/10.1080/20961790.2017.1330738

    Article  PubMed  PubMed Central  Google Scholar 

  19. Graziani G, Tal S, Adelman A, Kugel C, Bdolah-Abram T, Krispin A (2018) Usefulness of unenhanced post mortem computed tomography - findings in postmortem non-contrast computed tomography of the head, neck and spine compared to traditional medicolegal autopsy. J Forensic Leg Med 55:105–111. https://doi.org/10.1016/j.jflm.2018.02.022

    Article  PubMed  Google Scholar 

  20. Coty J-B, Nedelcu C, Yahya S, Dupont V, Rougé-Maillart C, Verschoore M et al (2018) Burned bodies: post-mortem computed tomography, an essential tool for modern forensic medicine. Insights Imaging 9:731–743. https://doi.org/10.1007/s13244-018-0633-2

    Article  PubMed  PubMed Central  Google Scholar 

  21. Levy AD, Harcke HT, Getz JM, Mallak CT (2009) Multidetector computed tomography findings in deaths with severe burns. Am J Forensic Med Pathol 30:137–141. https://doi.org/10.1097/PAF.0b013e3181879cc9

    Article  PubMed  Google Scholar 

  22. de Bakker HM, Roelandt GHJ, Soerdjbalie-Maikoe V, van Rijn RR, de Bakker BS (2019) The value of post-mortem computed tomography of burned victims in a forensic setting. Eur Radiol 29:1912–1921. https://doi.org/10.1007/s00330-018-5731-5

    Article  PubMed  Google Scholar 

  23. Thali MJ, Yen K, Plattner T, Schweitzer W, Vock P, Ozdoba C et al (2002) Charred body: virtual autopsy with multi-slice computed tomography and magnetic resonance imaging. J Forensic Sci 47:1326–1331

    PubMed  Google Scholar 

  24. Love JC, Wiersema JM (2016) Skeletal trauma: an anthropological review. Academic Forensic Pathology 6:463–77. https://doi.org/10.23907/2016.047

    Article  PubMed  PubMed Central  Google Scholar 

  25. Love JC, Symes SA (2004) Understanding rib fracture patterns: incomplete and buckle fractures. J Forensic Sci 49:1–6. https://doi.org/10.1520/JFS2004175

    Article  Google Scholar 

  26. Cartocci G, Santurro A, Neri M, Zaccagna F, Catalano C, La Russa R et al (2019) Post-mortem computed tomography (PMCT) radiological findings and assessment in advanced decomposed bodies. Radiol Med 124:1018–1027. https://doi.org/10.1007/s11547-019-01052-6

    Article  PubMed  Google Scholar 

  27. Jalalzadeh H, Giannakopoulos GF, Berger FH, Fronczek J, van de Goot FRW, Reijnders UJ et al (2015) Post-mortem imaging compared with autopsy in trauma victims–a systematic review. Forensic Sci Int 257:29–48. https://doi.org/10.1016/j.forsciint.2015.07.026

    Article  PubMed  Google Scholar 

  28. Morgan B, Adlam D, Robinson C, Pakkal M, Rutty GN (2014) Adult post-mortem imaging in traumatic and cardiorespiratory death and its relation to clinical radiological imaging. Br J Radiol 87:20130662. https://doi.org/10.1259/bjr.20130662

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Author notes

  1. Sarah Hammarlebiod and Audrey Farrugia contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, University Hospital of Strasbourg, 1 Avenue Molière, 67200, Strasbourg, France

    Sarah Hammarlebiod, Guillaume Bierry & Thibault Willaume

  2. Institute of Legal Medicine, Hospital of Strasbourg, University of Strasbourg, 11, rue Humann, 67085, Strasbourg cedex, France

    Audrey Farrugia & Jean-Sébastien Raul

Authors
  1. Sarah Hammarlebiod
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Audrey Farrugia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guillaume Bierry
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Sébastien Raul
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thibault Willaume
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Audrey Farrugia.

Ethics declarations

Ethical approval

The study complies with current ethical consideration. The protocol of this retrospective study was validated by the ethics committee of the French Society of Radiology.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hammarlebiod, S., Farrugia, A., Bierry, G. et al. Thermal bone injuries: postmortem computed tomography findings in 25 cases. Int J Legal Med 136, 219–227 (2022). https://doi.org/10.1007/s00414-021-02708-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00414-021-02708-7

Keywords

Search

Navigation