Hyperostosis Frontalis Interna: Forensic Issues

Abstract

The use of pathological conditions in age and sex determination, important factors in personal identification, is not widespread in anthropology and legal medicine. Hyperostosis frontalis interna (HFI) is a bone condition that mainly affects the inner table of the frontal bone. Although there are numerous publications on the subject, at the present time its etiology remains obscure. Several associations of symptoms, whose incidence varies according to the population studied, have been described. Age and gender appear to be linked with the preponderance of this condition, as does the presence of behavioral disturbances. The aim of our study, based on a series of 1532 autopsies, was to define the incidence and the associations observed with other pathological conditions. Thirteen cases of HFI were identified (0.8% of autopsies), 12 women and one man whose mean age was 59.15 years (range: 42–79 years). All had behavioral disturbances and most were under psychiatric care. This study emphasizes the value of this condition in medico-legal identification.

Increased osseous thickening of the inner surface of the frontal bone

“…Another important point is a need to verify the presence of osseous thickening in the other members of the family tree. Mechanism of occurrence of different types of osseous thickening, if it was constant or nodular, lobular and diffuse transitions are possible, is another subject of research (4,5,9). Thus, expansion of the lesion and its growth would cause complaints which would disturb the life quality of the patients.…”

Hyperostosis Frontalis Interna and sex identification of two skeletons from the Early Middle Ages necropolis of Vicenne‐Campochiaro (Molise, Italy)

“…A particular case is that of Hyperostosis Frontalis Interna (HFI), documented in many osteoarchaeological cases (Hahn & Czarnetzki, 1980;Armelagos & Chrisman, 1988;Gladykowska-Rzeczycka, 1988;Sperduti & Manzi, 1990;Watrous et al, 1993;Antò n, 1997;Buzhilova & Kozlovskaya, 2001;Rü hli et al, 2004;Devriendt et al, 2004) and the subject of clinical studies in modern populations (Devriendt et al, 2005). The prevalence of HFI is age-and sex-specific, and thus could help in age and sex determination in osteological materials (Ortner & Putschar, 1985;Devriendt et al, 2005).…”

“…This lesion is generally bilateral and the apposition can involve small areas the size of a grain of rice or even the entire internal surface of the frontal bone, which assumes a smooth, wavy or 'choppy sea' appearance (Mann & Murphy, 1990;Devriendt et al, 2005). In some cases, the hyperostosis extends to other bones, such as parietals, temporals and squamous part of the occipital (Ortner & Putschar, 1985;Antò n, 1997;Devriendt et al, 2004), without involving the outer table (Watrous et al, 1993).…”

“…MSM syndrome is a metabolic disorder typical of elderly women and associated with virilism, hirsutism, obesity and behavioural disorders. HFI can also result from hormonal disturbances (prolonged oestrogen stimulus during the reproductive period, menstrual disorders, hyperprolactinemia, galactorrhea), anomalous glucose regulation (diabetes mellitus), arterial hypertension, obesity and genetic factors (Armelagos & Chrisman, 1988;Watrous et al, 1993;Hershkovitz et al, 1999;Devriendt et al, 2005).…”

“…The prevalence of HFI in modern populations is still disputed, and the frequencies reported in the literature vary from 0.8% (Devriendt et al, 2005) to 12.8% (25% in females and 5% in males). These discordant values reflect the different study methods (direct observation, radiography).…”