Three-dimensional growth of tibial shaft ossification in the human fetus: a digital-image and statistical analysis

The developing juvenile distal tibia: Radiographic identification of distinct ontogenetic phases and structural trajectories

A novel combination of radiographic colour gradient mapping and radiographic absorptiometry was utilised to examine 96 human distal tibiae from 54 individuals ranging in age-at-death from the foetal to 23 years. The purpose of this was to identify previously undocumented changes in the internal organisation during the development of the distal tibia and determine whether these changes could be described as distinct phases. Previous studies have demonstrated a rudimentary structural organisation in other skeletal elements that mirror more mature patterns of bone organisation. Results showed that the perinatal tibia did not exhibit a rudimentary structural pattern similar to the architecture observed within the late adolescent tibia. This lack of early internal organisation is hypothesised to be related to the rudimentary ossification process that is being laid down around a pre-existing vascular template which will be subsequently modified by locomotive forces. Between birth and 2 years of age, the tibia exhibited a period of regression where radiodensity decreased in comparison to the perinatal tibia. This period of regression was postulated to be due to a combination of factors including changing locomotive forces, weaning and growth resulting in a stage of development which is extremely demanding on calcium liberation from the skeleton. After 2 years of age, the distal tibia demonstrated refinement where radiographic trajectories progressively developed into patterns consistent with adult trabecular organisation. These trajectories are linked to the forces associated with the bipedal gait, suggesting a strong influence of biomechanical forces on the development of the distal tibia.

Differential diagnosis of a calcified cyst found in an 18th century female burial site at St. Nicholas Church cemetery (Libkovice, Czechia)

During archaeological excavations in burial sites, sometimes stoned organic objects are found, in addition to human remains. Those objects might be of a different origin, depending on various factors influencing members of a community (i.e. diseases, trauma), which provides information about their living conditions. The St. Nicholas Church archaeological site (Libkovice, Czechia) in the 18^th century horizon of the cemetery, yielded a maturus-senilis female skeleton with a stone object in the left iliac fossa. This object was an oviform cyst-like rough structure, measuring 54 mm in length, 35 mm in maximum diameter and 0.2–0.7 mm shell thickness. Within the object there were small fetal bones (long bones, i.e. femur and two tibias, two scapulas, three ribs, vertebrae and other tiny bone fragments). Methods utilized to analyze the outer and inner surface morphology of the cyst and its inside, included: X-ray, CT imaging, SEM, histological staining and EDS. The EDS analysis revealed the presence of primarily oxygen, calcium and phosphorus in bone samples, and oxygen and silicon, in stone shell. Based on the length of the femur (20.2 mm) and tibia (16 mm) shafts, the fetal age was determined as being in the 15–18 week of pregnancy. The differential diagnosis was conducted, including for the three most probable cases: fetiform teratoma (FT), fetus-in-fetu (FIF) and lithopedion. The possibility of fetiform teratoma was discounted due to the presence of an anatomically correct spine, long bones and the proportions of the find. Although the low calcium content in the shell (2.3% atom mass), the lack of skull bones and the better developed lower limbs indicate fetus-in-fetu rather than lithopedion, the analyses results are unable to conclusively identify the object under one of these two categories since there are insufficient such cases in excavation material with which to draw comparison.