Bone-mineral density: clinical significance, methods of quantification and forensic applications

Bone-mineral density (BMD) is a measure of the inorganic mineral content inbone, and is one of the more informative assessments of bone quality in both clinical studiesand forensic investigations. Several factors, such as age, sex, disease, genetics, and lifestyle,affect BMD measurements, and normative standards must be applied for specific groups andindividuals. One of the most common disorders associated with low BMD is osteoporosisand increased fracture risk, due to a decrease in bone strength and an increase in bonefragility. Medical conditions like diabetes or hyperthyroidism and other parameters like peakbone mass and postmenopausal estrogen deficiency also impact BMD. Single- and dual-energy photon absorptiometry, quantitative computet tomography, and magnetic resonanceimaging are some of the technological modalities for BMD quantification, and each presentsdistinct advantages and limitations, depending on the purpose of the analysis, the specificcharacteristics of the individual, the bone site under examination, and the equipment andtrained personnel available. Recently, BMD values were applied to forensic medicine in avariety of scenarios ranging from age and sex estimation to the assessment of malnutritionand the use offinite-element modelling. Despite technical and methodological inconsisten-cies reported in the literature on BMD readings, there is scope for expanding the use of thisvariable in forensic settings

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