The role of the forensic anthropologist in the pediatric autopsy: Interpretations, contributions, and challenges

Child maltreatment is a growing medicolegal and social concern and forensic anthropologists in the United States are more frequently being asked to participate in pediatric autopsies to evaluate skeletal injuries. These injuries may be occult to medical imaging and the autopsy itself, but the forensic anthropologist directly evaluates the skeletal tissue which can dramatically improve the sensitivity and specificity of the analysis. The training and methods of forensic anthropologists provide them with the unique perspective of comprehending the anatomical, biomechanical, and physiological properties of human pediatric bone which informs their interpretations of time since injury and mechanism of trauma. This perspective also permits the ability to differentiate between growth and development, skeletal anomalies/variants, and traumatized bone which can be of distinct consequence to the forensic pathologist's cause and manner of death determination. This review is intended for forensic anthropologists and others in the medicolegal community who are tasked with identifying and interpreting pediatric skeletal trauma. The research and scholarly work cited herein is the most current bibliography for comprehending the role and contribution(s) of the forensic anthropologist in the pediatric autopsy, the techniques and methods available to them, and the challenges and cautions associated with this delicate work.