title: Spine injury following a low-energy trauma in ankylosing spondylitis: a study of two cases.
abstract: We report two cases of spine injury following a low-energy trauma in persons with ankylosing spondylitis (AS) and discuss the forensic considerations. A 60-year-old man presented with a wide anterior fracture of the superior endplate of T8 after an accidental fall down three wooden steps. A 93-year-old man presented with disjunction between C6 and C7 and 90-degree spinal angulation after a fall from a standing height or a fall from a bed. Post-mortem multislice computed tomography (MSCT) was performed before autopsy in both the cases. MSCT and autopsy findings were in agreement with a past medical history of AS. A spine injury occurring after a low-energy trauma is unusual and could be suspicious. In the forensic literature we found only a single case, which concerned multiple spinal fractures after a fall from a bicycle at low speed. Such specific mechanisms must be studied and known to the forensic expert. In this context, MSCT is a useful tool to investigate the spine and knowledge of the victim's entire past medical history is essential.
authors.affiliation: Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse Cedex 4 31403, France. Electronic address: savall.f@chu-toulouse.fr.
authors.forename: Frederic
authors.initials: F
authors.lastname: Savall
authors.affiliation: Service de Radiologie, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse Cedex 4 31403, France.
authors.forename: Fatima-Zohra
authors.initials: FZ
authors.lastname: Mokrane
authors.affiliation: Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse Cedex 4 31403, France; Service de Radiologie, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse Cedex 4 31403, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Dedouit
authors.affiliation: Service d'Anatomie Pathologique, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse Cedex 4 31403, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Capuani
authors.affiliation: Service d'Anatomie Pathologique, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse Cedex 4 31403, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Guilbeau-Frugier
authors.affiliation: Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse Cedex 4 31403, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rougé
authors.affiliation: Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse Cedex 4 31403, France.
authors.forename: Norbert
authors.initials: N
authors.lastname: Telmon
mesh_terms: D000058:Accidental Falls; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D013167:Spondylitis, Ankylosing / Q000150:complications*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*
keywords: Ankylosing spondylitis; Autopsy; Low-energy trauma; Multislice computed tomography; Post-mortem; Spine injury