Evidence Of Soft Tissue Research Articles

Exceptional soft tissue preservation reveals a cnidarian affinity for a Cambrian phosphatic tubicolous enigma.

Exoskeletal dwelling tubes are widespread among extant animals and early fossil assemblages. Exceptional fossils from the Cambrian reveal independent origins of tube dwelling by several clades including cnidarians, lophophorates, annelids, scalidophorans, panarthropods and ambulacrarians. However, most fossil tubes lack preservation of soft parts, making it difficult to understand their affinities and evolutionary significance. Gangtoucunia aspera (Wulongqing Formation, Cambrian Stage 4) was an annulated, gradually expanding phosphatic tube, with occasional attachments of multiple, smaller juveniles and has previously been interpreted as the dwelling tube of a 'worm' (e.g. a scalidophoran), lophophorate or problematicum. Here, we report the first soft tissues from Gangtoucunia that reveal a smooth body with circumoral tentacles and a blind, spacious gut that is partitioned by septa. This is consistent with cnidarian polyps and phylogenetic analysis resolves Gangtoucunia as a total group medusozoan. The tube of Gangtoucunia is phenotypically similar to problematic annulated tubular fossils (e.g. Sphenothallus, Byronia, hyolithelminths), which have been compared to both cnidarians and annelids, and are among the oldest assemblages of skeletal fossils. The cnidarian characters of G. aspera suggest that these early tubular taxa are best interpreted as cnidarians rather than sessile bilaterians in the absence of contrary soft tissue evidence.

COMPLETE UNILATERAL MAXILLECTOMY IN A COHORT OF FIVE COLOMBIAN BOAS (BOA IMPERATOR).

Five unrelated adult Colombian boas (Boa imperator) presented with a 1- to 3-mon history of unilateral rostral swelling of the maxilla associated with a chronic rubbing against the enclosure's walls. Moderate to severe gingival inflammation and ulceration of the labial mucosa were present at the level of the swelling with tenderness to the touch. Radiography revealed osteolytic or proliferative lesions of the maxillary bone. Chronic maxillary osteomyelitis was diagnosed. Unilateral maxillectomy was performed on each animal under general anesthesia. Local anesthesia was also achieved by infiltrating lidocaine along the medial and lateral aspect of the maxillary gingiva and at the level of the maxillo-ectopterygoid joint. Using a lateral gingival approach, the maxillo-prefrontal, maxillary-palatine, and maxillo-ectopterygoid attachments were transected, and the maxillary bone removed. Histologic examination revealed pyogranulomatous stomatitis and osteomyelitis in all snakes, and presence of intralesional bacteria (n = 3 snakes). Gram-negative bacteria (Chryseobacterium indologenes and Proteus mirabilis) were cultured from the resected tissue of two snakes. One snake suffered from wound dehiscence 5 d postoperatively. All snakes were fed 15 d postoperatively and ingested dead mice without apparent difficulties. One snake was examined 2 mon and 1 yr after surgery, with no evidence of soft tissue or osseous infection and only minor facial scaring; all other snakes were lost to follow-up 15 d after surgery. Unilateral maxillectomy was performed in a cohort of five Colombian boas suffering from maxillary osteomyelitis. This surgical technique should be considered as an alternative to medical treatment in boid snakes.

Neonatal line: A valuable evidence to prove female infanticide

Female infanticide is a widespread social problem in India. Majority of the cases of infanticide goes unreported, as there is a lack of proper evidence. It is very essential to distinguish live birth from stillbirth, to prove a case of infanticide. However, by the time, the mortal remains of the child are available for forensic examination, the body is decayed and putrefied; hence, soft-tissue evidence is lost. Although the chronological age of the child can be estimated by skeletal parameters, they cannot differentiate live birth and stillbirth. Thus, in such cases, the neonatal line is a valuable tool to prove female infanticide.

Soft-tissue evidence for homeothermy and crypsis in a Jurassic ichthyosaur.

Ichthyosaurs are extinct marine reptiles that display a notable external similarity to modern toothed whales. Here we show that this resemblance is more than skin deep. We apply a multidisciplinary experimental approach to characterize the cellular and molecular composition of integumental tissues in an exceptionally preserved specimen of the Early Jurassic ichthyosaur Stenopterygius. Our analyses recovered still-flexible remnants of the original scaleless skin, which comprises morphologically distinct epidermal and dermal layers. These are underlain by insulating blubber that would have augmented streamlining, buoyancy and homeothermy. Additionally, we identify endogenous proteinaceous and lipid constituents, together with keratinocytes and branched melanophores that contain eumelanin pigment. Distributional variation of melanophores across the body suggests countershading, possibly enhanced by physiological adjustments of colour to enable photoprotection, concealment and/or thermoregulation. Convergence of ichthyosaurs with extant marine amniotes thus extends to theultrastructural and molecular levels, reflecting the omnipresent constraints of their shared adaptation to pelagic life.

Taking stock: A systematic review of archaeological evidence of cancers in human and early hominin remains

This study summarizes data from 154 paleopathological studies documenting 272 archaeologically recovered individuals exhibiting skeletal or soft tissue evidence of cancer (malignant neoplastic disease) between 1.8 million years ago and 1900 CE. The paper reviews and summarizes the temporal, spatial and demographic distribution of the evidence and the methods used to provide the cancer diagnoses. Metastasis to bone is the most widely reported evidence (n = 161), followed by multiple myeloma (n = 55). In the dataset, males were represented more than females (M = 127, F = 94), and middle-adults (35–49) and old-adults (50+) were represented most among age groups (MA = 77, OA = 66). The majority of the evidence comes from Northern Europe (n = 51) and Northern Africa (n = 46). The data are summarized in the Cancer Research in Ancient Bodies (CRAB) Database, a growing online resource for future paleo-oncological research. This systematic review contributes to broader studies of malignant neoplastic disease in antiquity; it provides an overview of paleo-oncological data, discusses the many practical and methodological challenges of paleo-oncological research, and dispels presumptions about cancer’s rarity in the past.

New applications of spectroscopy techniques reveal phylogenetically significant soft tissue residue in Paleozoic conodonts

Spectroscopic evidence of soft tissue in conodont fossils strengthens evolutionary link to modern cyclostomes and the earliest vertebrates.

Nasal airflow simulations suggest convergent adaptation in Neanderthals and modern humans

Both modern humans (MHs) and Neanderthals successfully settled across western Eurasian cold-climate landscapes. Among the many adaptations considered as essential to survival in such landscapes, changes in the nasal morphology and/or function aimed to humidify and warm the air before it reaches the lungs are of key importance. Unfortunately, the lack of soft-tissue evidence in the fossil record turns difficult any comparative study of respiratory performance. Here, we reconstruct the internal nasal cavity of a Neanderthal plus two representatives of climatically divergent MH populations (southwestern Europeans and northeastern Asians). The reconstruction includes mucosa distribution enabling a realistic simulation of the breathing cycle in different climatic conditions via computational fluid dynamics. Striking across-specimens differences in fluid residence times affecting humidification and warming performance at the anterior tract were found under cold/dry climate simulations. Specifically, the Asian model achieves a rapid air conditioning, followed by the Neanderthals, whereas the European model attains a proper conditioning only around the medium-posterior tract. In addition, quantitative-genetic evolutionary analyses of nasal morphology provided signals of stabilizing selection for MH populations, with the removal of Arctic populations turning covariation patterns compatible with evolution by genetic drift. Both results indicate that, departing from important craniofacial differences existing among Neanderthals and MHs, an advantageous species-specific respiratory performance in cold climates may have occurred in both species. Fluid dynamics and evolutionary biology independently provided evidence of nasal evolution, suggesting that adaptive explanations regarding complex functional phenotypes require interdisciplinary approaches aimed to quantify both performance and evolutionary signals on covariation patterns.

Basal paravian functional anatomy illuminated by high-detail body outline

Body shape is a fundamental expression of organismal biology, but its quantitative reconstruction in fossil vertebrates is rare. Due to the absence of fossilized soft tissue evidence, the functional consequences of basal paravian body shape and its implications for the origins of avians and flight are not yet fully understood. Here we reconstruct the quantitative body outline of a fossil paravian Anchiornis based on high-definition images of soft tissues revealed by laser-stimulated fluorescence. This body outline confirms patagia-bearing arms, drumstick-shaped legs and a slender tail, features that were probably widespread among paravians. Finely preserved details also reveal similarities in propatagial and footpad form between basal paravians and modern birds, extending their record to the Late Jurassic. The body outline and soft tissue details suggest significant functional decoupling between the legs and tail in at least some basal paravians. The number of seemingly modern propatagial traits hint that feathering was a significant factor in how basal paravians utilized arm, leg and tail function for aerodynamic benefit.

Soft-tissue evidence of head injury in infants and young children: is CT head examination justified?

To determine whether it is justified to undertake a computed tomography (CT) examination of the head in children under 1 year of age who present with a bruise, swelling, or laceration of >5cm following head injury in children presenting to a paediatric accident and emergency (A&E) department in the northwest of England. Further aims were to determine whether there was any justification for performing a CT head examination for children with soft-tissue injuries measuring <5cm, or for children >1 year with evidence of soft-tissue injury, but without any other concerning feature. Children <3 years of age presenting with soft-tissue evidence of head injury between May 2011 and Oct 2014 and who subsequently underwent head CT were retrospectively identified from radiology requests. The CT images and clinical notes were used to identify those with skull fracture or intracranial haemorrhage and to determine whether the child was subsequently admitted or discharged from A&E. Eighty-five CT head examinations met the criteria for inclusion. Of these, 45 examinations demonstrated skull fractures and four examinations identified intracranial haemorrhage. Thirty-eight requests included soft-tissue evidence of head injury as the sole reason indicated for CT head examination. Of these, 22 examinations demonstrated skull fractures and one examination identified intracranial haemorrhage. Soft-tissue evidence of head injury as the sole reason for CT head examination appears to be justified in the present patient population. Furthermore, this study suggests that CT head examination should also be considered for children with soft-tissue injuries of <5cm and for children aged between 1 and 3 years if identification of a skull fracture would alter the child's management.

Observations of sacrocaudal fusion in Greyhounds and other dogs.

To describe the incidence and forms of nonpathological sacrocaudal fusion in racing Greyhounds and compare them with those in a variety of other domestic dog breeds. This retrospective observational study used archived anatomical specimens from 81 racing Greyhounds and 10 Beagles, and archived clinical radiographs from 81 non-Greyhound dogs representing 37 other breeds. Dogs less than two years of age and dogs with evidence of soft tissue or osseous pathology involving the sacrocaudal region were excluded. The incidence of osseous sacrocaudal fusion (any type and complete fusion) was compared between Greyhounds and all of the other dogs combined, using the Fisher's exact test. Sacrocaudal fusion of some type was found in 33 (41%) of 81 Greyhounds but in only 14 (15%) of 91 non-Greyhound dogs (p <0.01). Complete fusion (osseous fusion of vertebral bodies and both transverse and articular processes) between the sacrum and the first caudal vertebra was the most common form in Greyhounds, found in 27 (33%) of 81 Greyhounds, but in only three (3.3%) of 91 non-Greyhound dogs (p <0.01). Sacrocaudal fusion appears to be more prevalent in Greyhounds than in other domestic dog breeds and may be attributable to selection pressure for speed on a region of the spine that is naturally prone to variation. Its significance for performance and soundness requires further study.

2012 Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infectionsa

Foot infections are a common and serious problem in persons with diabetes. Diabetic foot infections (DFIs) typically begin in a wound, most often a neuropathic ulceration. While all wounds are colonized with microorganisms, the presence of infection is defined by ≥2 classic findings of inflammation or purulence. Infections are then classified into mild (superficial and limited in size and depth), moderate (deeper or more extensive), or severe (accompanied by systemic signs or metabolic perturbations). This classification system, along with a vascular assessment, helps determine which patients should be hospitalized, which may require special imaging procedures or surgical interventions, and which will require amputation. Most DFIs are polymicrobial, with aerobic gram-positive cocci (GPC), and especially staphylococci, the most common causative organisms. Aerobic gram-negative bacilli are frequently copathogens in infections that are chronic or follow antibiotic treatment, and obligate anaerobes may be copathogens in ischemic or necrotic wounds. Wounds without evidence of soft tissue or bone infection do not require antibiotic therapy. For infected wounds, obtain a post-debridement specimen (preferably of tissue) for aerobic and anaerobic culture. Empiric antibiotic therapy can be narrowly targeted at GPC in many acutely infected patients, but those at risk for infection with antibiotic-resistant organisms or with chronic, previously treated, or severe infections usually require broader spectrum regimens. Imaging is helpful in most DFIs; plain radiographs may be sufficient, but magnetic resonance imaging is far more sensitive and specific. Osteomyelitis occurs in many diabetic patients with a foot wound and can be difficult to diagnose (optimally defined by bone culture and histology) and treat (often requiring surgical debridement or resection, and/or prolonged antibiotic therapy). Most DFIs require some surgical intervention, ranging from minor (debridement) to major (resection, amputation). Wounds must also be properly dressed and off-loaded of pressure, and patients need regular follow-up. An ischemic foot may require revascularization, and some nonresponding patients may benefit from selected adjunctive measures. Employing multidisciplinary foot teams improves outcomes. Clinicians and healthcare organizations should attempt to monitor, and thereby improve, their outcomes and processes in caring for DFIs.

Executive Summary: 2012 Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infectionsa

Foot infections are a common and serious problem in persons with diabetes. Diabetic foot infections (DFIs) typically begin in a wound, most often a neuropathic ulceration. While all wounds are colonized with microorganisms, the presence of infection is defined by ≥2 classic findings of inflammation or purulence. Infections are then classified into mild (superficial and limited in size and depth), moderate (deeper or more extensive), or severe (accompanied by systemic signs or metabolic perturbations). This classification system, along with a vascular assessment, helps determine which patients should be hospitalized, which may require special imaging procedures or surgical interventions, and which will require amputation. Most DFIs are polymicrobial, with aerobic gram-positive cocci (GPC), and especially staphylococci, the most common causative organisms. Aerobic gram-negative bacilli are frequently copathogens in infections that are chronic or follow antibiotic treatment, and obligate anaerobes may be copathogens in ischemic or necrotic wounds. Wounds without evidence of soft tissue or bone infection do not require antibiotic therapy. For infected wounds, obtain a post-debridement specimen (preferably of tissue) for aerobic and anaerobic culture. Empiric antibiotic therapy can be narrowly targeted at GPC in many acutely infected patients, but those at risk for infection with antibiotic-resistant organisms or with chronic, previously treated, or severe infections usually require broader spectrum regimens. Imaging is helpful in most DFIs; plain radiographs may be sufficient, but magnetic resonance imaging is far more sensitive and specific. Osteomyelitis occurs in many diabetic patients with a foot wound and can be difficult to diagnose (optimally defined by bone culture and histology) and treat (often requiring surgical debridement or resection, and/or prolonged antibiotic therapy). Most DFIs require some surgical intervention, ranging from minor (debridement) to major (resection, amputation). Wounds must also be properly dressed and off-loaded of pressure, and patients need regular follow-up. An ischemic foot may require revascularization, and some nonresponding patients may benefit from selected adjunctive measures. Employing multidisciplinary foot teams improves outcomes. Clinicians and healthcare organizations should attempt to monitor, and thereby improve, their outcomes and processes in caring for DFIs.

2012 Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infectionsa

Foot infections are a common and serious problem in persons with diabetes. Diabetic foot infections (DFIs) typically begin in a wound, most often a neuropathic ulceration. While all wounds are colonized with microorganisms, the presence of infection is defined by ≥2 classic findings of inflammation or purulence. Infections are then classified into mild (superficial and limited in size and depth), moderate (deeper or more extensive), or severe (accompanied by systemic signs or metabolic perturbations). This classification system, along with a vascular assessment, helps determine which patients should be hospitalized, which may require special imaging procedures or surgical interventions, and which will require amputation. Most DFIs are polymicrobial, with aerobic gram-positive cocci (GPC), and especially staphylococci, the most common causative organisms. Aerobic gram-negative bacilli are frequently copathogens in infections that are chronic or follow antibiotic treatment, and obligate anaerobes may be copathogens in ischemic or necrotic wounds. Wounds without evidence of soft tissue or bone infection do not require antibiotic therapy. For infected wounds, obtain a post-debridement specimen (preferably of tissue) for aerobic and anaerobic culture. Empiric antibiotic therapy can be narrowly targeted at GPC in many acutely infected patients, but those at risk for infection with antibiotic-resistant organisms or with chronic, previously treated, or severe infections usually require broader spectrum regimens. Imaging is helpful in most DFIs; plain radiographs may be sufficient, but magnetic resonance imaging is far more sensitive and specific. Osteomyelitis occurs in many diabetic patients with a foot wound and can be difficult to diagnose (optimally defined by bone culture and histology) and treat (often requiring surgical debridement or resection, and/or prolonged antibiotic therapy). Most DFIs require some surgical intervention, ranging from minor (debridement) to major (resection, amputation). Wounds must also be properly dressed and off-loaded of pressure, and patients need regular follow-up. An ischemic foot may require revascularization, and some nonresponding patients may benefit from selected adjunctive measures. Employing multidisciplinary foot teams improves outcomes. Clinicians and healthcare organizations should attempt to monitor, and thereby improve, their outcomes and processes in caring for DFIs.

Anteroposterior Spondyloschisis of Atlas with Bilateral Cleft Defect of Posterior Arch

case report and review of the literature. to report on a patient presenting with anteroposterior defects of the arch of the atlas with a rare type of posterior arch defect. This report includes a literature review of the hypothesis for the development of this anomaly. congenital bony defects of the atlas are uncommon. Isolated posterior clefts are the most frequent anomaly, but combined anterior and posterior defects are the least common. In particular, combined anteroposterior defects of the arch of the atlas with other types of posterior arch defects, not including type A, have not been reported. These anomalies can cause confusion, particularly in the setting of trauma when the radiologic finding may be misinterpreted as representing a fracture. we report here on a 22-year-old man with an anteroposterior defect of the atlas who complained of neck pain after a traffic accident. The computed tomography demonstrated well-corticated defects with sclerotic changes and no evidence of soft tissue swelling adjacent to the bony discontinuities, consistent with a congenital abnormality. Suspecting anteroposterior spondyloschisis, we performed only conservative treatment. the patient improved on conservative therapy without a surgical procedure. we describe combined anteroposterior defects of the arch of the atlas along with other types of posterior arch defects. Most congenital defects of the arch of the atlas are found during radiologic evaluation of neck pain after trauma. Careful diagnosis is needed for these patients to avoid confusing these defects with a fracture.

An Anthropological Analysis of Gunshot Wounds to the Chest*

This analysis of gunshot trauma to the bony thorax examines 87 handgun and rifle wounds from documented cases in an effort to corroborate an earlier report and to provide the forensic community with additional literature in this area. Specifically, this study tests whether the trauma signatures associated with gunshot wounds in the bony thorax are useful in determining the direction of fire. Because the ribs occupy a significant portion of the bony thorax, they are struck more frequently than other bones and, consequently, they are the focus of this report. This study confirmed that bullets can leave distinctive markers on ribs that indicate the direction of fire, including depressed fractures, bone fragments displaced in the direction of the bullet's path, and beveling. Although forensic anthropologists can determine the direction that a bullet was traveling when it struck a given rib, they cannot give a definitive statement about the number or sequence of gunshots without supporting soft tissue evidence.

A fatal case of community acquired methicillin resistant Staphylococcus aureus brain abscess in a previously healthy adolescent

A 16-year-old adolescent presented with fever, lethargy and vomiting associated with mild dehydration. This was followed less than 24-hours later by loss of consciousness, seizures and clinical brain death. She had no prior medical illness, no hospital or frequent antibiotic exposure. There was no evidence of soft tissue or skin infection. Management included intravenous fluids, ampicillin and cefotaxime parenterally, dexamethasone, endotracheal intubation and mechanical ventilation. Her neurologic examination remained unchanged with areflexia, flaccid paralysis and fixed pupils. Post-mortem examination revealed an eight-centimetre right fronto-parietal lobe brain abscess. Cultures were positive for methicillin resistant Staphylococcus aureus. Although formerly a nosocomial pathogen affecting debilitated patients in the hospital setting, S aureus that is methicillin resistant is emerging as a community acquired pathogen affecting previously well patients.

Pairwise difference analysis in modern human origins research.

Pairwise difference analysis is a phenetic method that groups taxa on the basis of the number of differences they exhibit. Recently, pairwise difference analysis has been used to investigate the phylogenetic relationships of hominid fossils at the centre of the modern human origins debate. It has been argued that the results of these analyses disprove the African replacement model of modern human origins, and support instead its competitor, the multiregional evolution model. However, this inference is problematic because the ability of pairwise difference analysis to recover phylogenetic information from morphological data has not been demonstrated. With this in mind, we conducted pairwise difference analyses of craniodental and soft tissue evidence from a group of extant primates for which a reliable molecular phylogeny is available, the hominoids. We found that the phylogenies yielded by the pairwise difference analyses were incompatible with the molecular phylogeny for the group. Given the robustness of the molecular phylogeny, these results suggest that pairwise difference analysis cannot be relied on to generate reliable estimates of primate phylogeny from morphological data. The corollary of this is that the results of published pairwise difference analyses of hominid fossils are not informative regarding the origin of modern humans.

Conodont anatomy, chordate phylogeny and vertebrate classification

Interpretations of conodont anatomy and affinity continue to generate controversy. Fossilized soft-tissue evidence indicates that conodonts possessed eyes, extrinsic eye muscles, a notochord, myomeres, a differentiated tail with fin radiais, possible otic capsules and possible branchial structures. Indirect evidence suggests a differentiated brain and cartilaginous head skeleton. The multi-component phosphatic tissue complexes of the conodont feeding apparatus cannot be compared to the amorphous apatite of extant agnathan otoliths. By limiting cladistic analysis to a restricted selection of these characters the hypothesis that conodonts are a sister group of the clade comprising extant hagfish, lampreys and gnathostomes can be supported. However, exhaustive analysis of a more complete character-set strongly supports the hypothesis that conodonts are more derived than hagfish. From a taxonomic perspective, these two hypotheses have no effect on how conodonts should be classified. Whether they are a stem group (the former hypothesis) or part of the crown group (the latter), conodonts are clearly part of the total group Vertebrata (=Craniata).

Soft anatomy and the affinities of conodonts

Recent claims that conodonts are members of the Craniata or Vertebrata are based in part upon soft tissue features that have been preserved in a small number of specimens. These features include what appear to be radials in the caudal fin and paired structures that have been identified as eye remnants. The evidence for radials is limited, but credible. However, the anatomy of extant cyclostomes suggests that the paired structures are more reasonably interpreted as otic capsules than the remnants of sclerotic eye capsules. Moreover, even if these structures are the remnants of eyes, conodonts might equally well be a sister group to the craniates as a member of that group. Aside from these paired structures, conodont fossils exhibit no features that are suggestive of a cartilaginous skeleton. Given that cyclostome fossils sometimes show evidence of the cartilages of the head, the apparent absence of a similar skeleton in conodont animals calls into question the claim that they are craniates. The simple single chevron shape of conodont myomeres also suggests that they lie outside of the Craniata. All living craniates have double-chevron myomeres as adults, whereas simple myomeres of the conodont type are found in the non-craniate cephalochordates. Thus the available soft tissue evidence suggests that conodonts are best regarded as the sister group of the craniates.

The role of bone scintigraphy in detecting child abuse

This review of diagnostic imaging in cases of suspected child abuse characterizes the significant differences between bone scintigraphy and x-ray evaluation, describes the advantages and disadvantages of each modality, postulates on the specific mechanisms of injury that produce the characteristic scintigraphic findings, and emphasizes the influences that scintigraphic studies have on the medical, social, and legal aspects of child abuse. The major advantages of bone scintigraphy are its increased sensitivity (25% to 50%) in detecting evidence of soft tissue as well as bone trauma in child abuse. Furthermore, it is postulated that the specific mechanisms of inflicting the trauma relate to the patient's size and are characterized by bone scintigraphy. During fits of anger or frustration, the perpetrator of child abuse grasps the small infant or child by the thorax during the shaking activity. This produces characteristic rib injuries. The older and heavier child is more likely to be grabbed by the extremities, which produces periosteal injuries manifested as characteristic abnormal localizations in the diaphyses of the extremities. The roentgenograms of these injuries are frequently normal. The importance of bone scintigraphy is its complementary nature in defining and characterizing the extent and severity of trauma from child abuse. Such findings have direct bearing on the medical, social, and legal outcomes for the abused child. The quality of scintigraphic imaging is important, requiring the use of magnification techniques in the infant. The interpretation of the scintigraphic images depends on an understanding of the mechanisms by which the radionuclide localizes in bone. The same traumatic incident can lead to decreased, normal, or increased localization at the trauma site. Radionuclide scintigraphy is a complementary rather than competitive imaging modality to X-ray evaluation in the diagnosis and management of physical child abuse.