Microfocus CT (micro-CT) is an imaging method that provides three-dimensional digital data sets with comparable resolution to light microscopy. Although it has traditionally been used for non-destructive testing in engineering, aerospace industries and in preclinical animal studies, new applications are rapidly becoming available in the clinical setting including post-mortem fetal imaging and pathological specimen analysis. Printing three-dimensional models from imaging data sets for educational purposes is well established in the medical literature, but typically using low resolution (0.7 mm voxel size) data acquired from CT or MR examinations. With higher resolution imaging (voxel sizes below 1 micron, <0.001 mm) at micro-CT, smaller structures can be better characterised, and data sets post-processed to create accurate anatomical models for review and handling. In this review, we provide examples of how three-dimensional printing of micro-CT imaged specimens can provide insight into craniofacial surgical applications, developmental cardiac anatomy, placental imaging, archaeological remains and high-resolution bone imaging. We conclude with other potential future usages of this emerging technique.

Cribra orbitalia has been the subject of much discussion since first described in the late 19th century. In particular, its relationship to porotic hyperostosis, anaemia, and malaria has been considered on many occasions. We have examined historical, embryological, developmental, anatomical, and pathological data to try to determine the significance of cribra. We conclude that three separate conditions have been included under this rubric: simple orbital porosity (cribra orbitalia sensu strictu), which is a normal developmental variant; deposits of periosteal new bone on the orbital roof; and an extensive inflammatory enlargement of the inner face of the orbital roof. These final two classes are pathological conditions that lead to a convex appearance of the orbital roof. In contradiction to authors treating cribra orbitalia as a precursor to porotic hyperostosis, we conclude that there is no evidence that the two are causally related. Consequently, cribra orbitalia sensu strictu should not be used as a surrogate for either anaemia or malaria.

This report describes a putative case of a treponemal infection observed on a skeleton of a young male adult from the Apple Down Anglo-Saxon cemetery dating to the sixth century AD, accompanied by grave goods indicative of a high status burial. The skeleton is well preserved and almost complete. The pathological evidence includes an extensive area of lytic destruction to the frontal bone of the skull, widespread profuse bilateral symmetrical periosteal reaction affecting scapulae, clavicles, arms, legs, hands, feet and ribs. There is also evidence of gummatous destruction on some of the long bones. Application of a differential diagnosis of all probable diseases exhibiting the individual symptoms leads to a clear conclusion that the person was infected with a treponemal pathogen. The skeleton shows none of the stigmata associated with the congenital form of treponemal disease. We propose that the evidence suggests a possible case of venereal syphilis rather than one of the endemic forms of treponemal disease. This diagnosis is based on the geographical pathogen range, the apparent low prevalence of the disease, significant social upheaval at the time, the high social status and early age of death of the individual.

No abstract

Excavations in the 1990s at the medieval Chapter House of Worcester Cathedral, UK, revealed medieval human skeletal remains, some of which exhibited a distinctive purple coloration. The nature of the colored bone was investigated using solvents for stain extraction, scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), X-ray fluorescence (XRF), plane polarized (PPL) and cross-polarized (XPL) light microscopy, and auto fluorescence (AF) microscopy. Normal bone from the cemetery was used as a control. The color does not arise from a stain soluble in normal organic solvents. EDX and XRD analysis showed no significant difference between purple and normal bone. XRF analysis shows the presence of trace levels of iron, manganese, zinc, and copper in the affected material. This exhibited a pink color in acid phase and a blue color in alkaline phase. These two states were reversible. The alkaline phase gradually changed irreversibly to yellow over time. These data suggest that the coloration is consistent with the presence of high levels of purple acid phosphatase (PAP) enzyme. The presence of trace amounts of iron, manganese, zinc, and copper suggests a plant or fungal origin for the putative PAP, possibly a member of the Aspergillus ficuum species.