Radiographic comparison of a fractured clavicle exhibiting a pseudo-arthrosis

Bone remodeling is a natural process that is potentially problematic for radiographic comparisons because it can occur after antemortem (AM) imaging, thus interfering with the comparability of AM and postmortem (PM) radiographs from the same individual. While the effects of age-related remodeling have been studied, limited attention has been given to trauma-related remodeling with respect to radiographic comparisons. This report adds to the latter topic by presenting a case of AM clavicle fracture that developed into a pseudo-arthrosis over a 12-month period prior to the individual's death. Even though remodeling was discernable along the fracture margins, adjacent skeletal features on the PM radiograph remained unaltered and constituted compelling evidence for the identification. This case illustrates the potential of using both normal and pathological anatomy concurrently to maximize the surety of findings from radiographic comparisons.