The recognition and diagnosis of pathological conditions can provide identifying characteristics that lead to the identification of unknown remains. While pathological lesions on dry bone are usually detected by gross visual examination, potentially individuating lesions may not be detected without radiographic analysis. Radiography may be especially important to diagnose metastatic cancer, where lesions may begin on the inner surface of the bone. The objective of this study was to determine if and on what skeletal elements metastatic cancerous lesions are detected more frequently when using radiographs compared to dry bone examination. Multiple skeletal elements from 30 individuals with reported soft tissue cancers were examined for the presence of visible lesions on dry bone and on radiographs. Results show that 63% of the sample with reported soft tissue cancers exhibited visible lesions. Of these, 42% of the lesions were identified solely on radiographs and 58% exhibited distinct lesions using both dry bone and radiographic analyses. A comparison of the two methods of lesion detection indicates that macroscopic analysis alone cannot capture the range of cancerous lesion manifestations. Here, I suggest a method for practitioners that minimizes time and expense in radiographing to prioritize skeletal elements that best exhibit cancerous lesions that would have otherwise been hidden on dry bone.
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