Hyperostosis frontalis interna, a clue in the reconstructive identification of skeletons. Epidemiology of an autopsy population at Limoges University Hospital (France).

BACKGROUND

Hyperostosis Frontalis Interna (HFI) is a localized thickening of the inner table of the frontal bone, frequently observed in postmenopausal women. Although often overlooked, it may provide valuable information for reconstructive identification in forensic contexts.

METHODS

We conducted a macroscopic analysis of 195 autopsied individuals at Limoges University Hospital (France) to assess the prevalence of HFI and its associations with age, sex, and medical history.

RESULTS

HFI was identified in 13.8 % of cases, with a striking sex disparity: 38.8 % of females presented with HFI compared to only 0.78 % of males (p < 0.0001). A significant association with older age was observed (mean age 66.3 years in HFI-positive vs. 48.4 years in HFI-negative individuals, p < 0.00001). The presence of HFI predicted female sex with a positive predictive value of 96.3 %. A significant association was also found with a history of depression.

CONCLUSION

Although HFI has limited sensitivity, its high specificity and ease of detection make it a useful auxiliary marker in reconstructive identification. It may help narrow the biological profile in cases involving degraded or incomplete remains. Further multicenter studies are needed to validate its forensic utility.