Assault victims can develop multiple complications from physical and psychological damage to aggravation of previous medical conditions, with many forensic consequences. A 51-year male, known with type 1 diabetes mellitus and autoimmune hypothyroidism, was the victim of a traumatic assault on the street. The patient had multiple bruises but no fractures. The bruises healed normally but anterior cervical and abdominal pain persisted for more than 2 weeks so he was referred for further investigation. The ultrasound examination suggested a small hemorrhage in previously unknown thyroid nodules and also in a newly discovered adrenal mass. Thyroidectomy was recommended and the pathological examination diagnosed squamous metaplasia. After a complete hormonal evaluation, the patient also underwent unilateral adrenalectomy and a benign corticoadenoma was found. A traumatic event may contribute to the diagnosis of otherwise asymptomatic or even unusual pathology such as Hashimoto thyroiditis (HT)-associated macronodular thyroid disease involving a squamous metaplasia associated with an adrenal non-functioning tumor. If physical or psychological stress may play a pathogenic role for these co-morbidities is still a matter of debate.

Introduction. Primary osteoporosis in men is significantly less frequent than in women but is similarly associated with an increased risk of fractures (including fragility fractures i.e.fractures that occurr without any causal trauma). Vertebrae are common sites for fragility fractures which can be oligo-or completely asymptomatic. Case report. We present the case of a man diagnosed after a traumatic event with both severe spine fractures and agerelated osteoporosis. A 65-year non-smoking Caucasian man with negative medical history suffered a spine trauma during his work in constructions. Fractures at T12 and L1 were diagnosed and surgically managed (T12 laminectomy and T12-L1 bilateral titanium osteosynthesis). Osteoporosis was also confirmed by DXA osteodensitometry. He received antiosteoporotic treatment (bisphosphonates, vitamin D supplementation) but at the 1 year-follow-up visit a new fragility fracture (T7 vertebra) was diagnosed. The occurrence of fragility fractures despite active antiosteoporotic treatment raised significant dillemas related to the individual contributions of osteoporosis and trauma to the initial, apparently posttraumatic vertebral fractures. Conclusion. In the presence of confirmed osteoporosis (a condition with increased risk of spontaneous vertebral fractures, frequently asymptomatic) it is very difficult to correctly discern the contribution of a spinal trauma to the etiopathogenesis of vertebral fractures.