The use of bone mineral density in forensic medicine: A systematic review

IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging Pub Date : 2026-05-01 Epub Date: 2026-05-14 DOI:10.1016/j.fri.2026.200777

Dennis Vinther, Kasper Hansen, Troels Græsholt-Knudsen, Lene Warner Thorup Boel, Lars Uhrenholt

{"title":"The use of bone mineral density in forensic medicine: A systematic review","authors":"Dennis Vinther, Kasper Hansen, Troels Græsholt-Knudsen, Lene Warner Thorup Boel, Lars Uhrenholt","doi":"10.1016/j.fri.2026.200777","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>There is a growing interest in the role of BMD in forensic settings. For example, a reduced bone quality, i.e. low BMD, could influence the interpretation of a particular trauma. This could ultimately impact the determination of the manner of death. The aim of this study is to review the current literature to clarify when and how BMD estimation has been applied to forensic cases.</div></div><div>There is a growing interest in the role of BMD in forensic settings. For example, a reduced bone quality, i.e. low BMD, could influence the interpretation of a particular trauma. This could ultimately impact the determination of the manner of death. The aim of this study is to review the current literature to clarify when and how BMD estimation has been applied to forensic cases.</div><div><h3>Materials and Methods</h3><div>A systematic review of the existing literature (PubMed) was conducted using the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. The search string included terms related to BMD estimation in a forensic population.</div></div><div>A systematic review of the existing literature (PubMed) was conducted using the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. The search string included terms related to BMD estimation in a forensic population.</div><div><h3>Results</h3><div>The preliminary results include a total of 26 studies in the period 2005 to 2024. All studies used imaging modalities for BMD-estimation. A total of 13 studies used DEXA, 11 used CT, and 3 used micro-CT. Following were some of the findings:</div><div>BMD-estimations have predominantly been used for age and sex estimations in cadavers and skeletal remains.</div><div>A correlation between BMD and body weight have been shown in skeletal remains. Reduced BMD had been observed in subjects with chronic alcohol abuse.</div><div>A strong correlation between BMD and minimum diameter after gunshots to the cranium.</div><div>A case-study examined that BMD could be helpful to identify malnutrition and to understand fracture patterns in specific cases.</div><div>An osteoarchaeological study found a relationship between BMD, stature and socioeconomic status in a medieval population.</div><div>Micro-CT has been used for age estimations in adult cadavers and in infant skeletal remains. Furthermore, micro-CT has been used to investigate the shape development of pars basilaris in early postnatal life, using skeletal remains.</div></div><div>The preliminary results include a total of 26 studies in the period 2005 to 2024. All studies used imaging modalities for BMD-estimation. A total of 13 studies used DEXA, 11 used CT, and 3 used micro-CT. Following were some of the findings:</div><div>BMD-estimations have predominantly been used for age and sex estimations in cadavers and skeletal remains.</div><div>A correlation between BMD and body weight have been shown in skeletal remains. Reduced BMD had been observed in subjects with chronic alcohol abuse.</div><div>A strong correlation between BMD and minimum diameter after gunshots to the cranium.</div><div>A case-study examined that BMD could be helpful to identify malnutrition and to understand fracture patterns in specific cases.</div><div>An osteoarchaeological study found a relationship between BMD, stature and socioeconomic status in a medieval population.</div><div>Micro-CT has been used for age estimations in adult cadavers and in infant skeletal remains. Furthermore, micro-CT has been used to investigate the shape development of pars basilaris in early postnatal life, using skeletal remains.</div><div><h3>Conclusions</h3><div>The full potential of BMD-estimations in forensic medicine is not yet covered. The current literature indicates that BMD-estimations could be useful for improving human identification and support case-specific forensic analyses.</div></div><div>The full potential of BMD-estimations in forensic medicine is not yet covered. The current literature indicates that BMD-estimations could be useful for improving human identification and support case-specific forensic analyses.</div>","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200777"},"PeriodicalIF":0.9000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Forensic Imaging","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666225626001089","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/5/14 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Background

There is a growing interest in the role of BMD in forensic settings. For example, a reduced bone quality, i.e. low BMD, could influence the interpretation of a particular trauma. This could ultimately impact the determination of the manner of death. The aim of this study is to review the current literature to clarify when and how BMD estimation has been applied to forensic cases.

Materials and Methods

A systematic review of the existing literature (PubMed) was conducted using the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. The search string included terms related to BMD estimation in a forensic population.

Results

The preliminary results include a total of 26 studies in the period 2005 to 2024. All studies used imaging modalities for BMD-estimation. A total of 13 studies used DEXA, 11 used CT, and 3 used micro-CT. Following were some of the findings:

BMD-estimations have predominantly been used for age and sex estimations in cadavers and skeletal remains.

A correlation between BMD and body weight have been shown in skeletal remains. Reduced BMD had been observed in subjects with chronic alcohol abuse.

A strong correlation between BMD and minimum diameter after gunshots to the cranium.

A case-study examined that BMD could be helpful to identify malnutrition and to understand fracture patterns in specific cases.

An osteoarchaeological study found a relationship between BMD, stature and socioeconomic status in a medieval population.

Micro-CT has been used for age estimations in adult cadavers and in infant skeletal remains. Furthermore, micro-CT has been used to investigate the shape development of pars basilaris in early postnatal life, using skeletal remains.

BMD-estimations have predominantly been used for age and sex estimations in cadavers and skeletal remains.

A correlation between BMD and body weight have been shown in skeletal remains. Reduced BMD had been observed in subjects with chronic alcohol abuse.

A strong correlation between BMD and minimum diameter after gunshots to the cranium.

A case-study examined that BMD could be helpful to identify malnutrition and to understand fracture patterns in specific cases.

An osteoarchaeological study found a relationship between BMD, stature and socioeconomic status in a medieval population.

Conclusions

The full potential of BMD-estimations in forensic medicine is not yet covered. The current literature indicates that BMD-estimations could be useful for improving human identification and support case-specific forensic analyses.

查看原文本刊更多论文

骨矿物质密度在法医学中的应用：系统综述

人们对骨密度在法医环境中的作用越来越感兴趣。例如，骨质量降低，即骨密度低，可能影响对特定创伤的解释。这可能最终影响死亡方式的确定。本研究的目的是回顾当前的文献，以澄清BMD估计何时以及如何应用于法医案件。人们对骨密度在法医环境中的作用越来越感兴趣。例如，骨质量降低，即骨密度低，可能影响对特定创伤的解释。这可能最终影响死亡方式的确定。本研究的目的是回顾当前的文献，以澄清BMD估计何时以及如何应用于法医案件。材料和方法使用系统评价首选报告项目（PRISMA）清单对现有文献（PubMed）进行系统评价。搜索字符串包括与法医种群中BMD估计相关的术语。使用系统评价首选报告项目（PRISMA）清单对现有文献（PubMed）进行系统评价。搜索字符串包括与法医种群中BMD估计相关的术语。结果初步结果包括2005 ~ 2024年共26项研究。所有的研究都使用成像方式来估计骨密度。共有13项研究使用DEXA， 11项使用CT， 3项使用micro-CT。以下是一些发现：骨密度估计主要用于尸体和骨骼遗骸的年龄和性别估计。骨密度和体重之间的相关性已在骨骼遗骸中得到证实。在慢性酒精滥用的受试者中观察到骨密度降低。骨密度和头盖骨中枪后的最小直径有很强的相关性。一项案例研究表明，骨密度可以帮助识别营养不良和了解特定病例的骨折模式。一项骨考古研究发现，在中世纪人群中，骨密度、身材和社会经济地位之间存在关系。Micro-CT已被用于成人尸体和婴儿骨骼遗骸的年龄估计。此外，微型ct已被用于研究出生后早期生活中基底部的形状发展，使用骨骼遗骸。初步结果包括2005年至2024年期间共26项研究。所有的研究都使用成像方式来估计骨密度。共有13项研究使用DEXA， 11项使用CT， 3项使用micro-CT。以下是一些发现：骨密度估计主要用于尸体和骨骼遗骸的年龄和性别估计。骨密度和体重之间的相关性已在骨骼遗骸中得到证实。在慢性酒精滥用的受试者中观察到骨密度降低。骨密度和头盖骨中枪后的最小直径有很强的相关性。一项案例研究表明，骨密度可以帮助识别营养不良和了解特定病例的骨折模式。一项骨考古研究发现，在中世纪人群中，骨密度、身材和社会经济地位之间存在关系。Micro-CT已被用于成人尸体和婴儿骨骼遗骸的年龄估计。此外，微型ct已被用于研究出生后早期生活中基底部的形状发展，使用骨骼遗骸。结论骨密度估算在法医学中的潜力尚未充分发挥。目前的文献表明，bmd估计可能有助于提高人类识别和支持具体案例的法医分析。法医医学中骨密度估算的全部潜力尚未被涵盖。目前的文献表明，bmd估计可能有助于提高人类识别和支持具体案例的法医分析。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Forensic Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.20

自引率

27.30%

发文量