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Wormian bones (WB) are the irregular bone structures developed from additional centers of ossification. Although they are commonly found in healthy individuals, under certain conditions (number >10, mosaic pattern, large size), they can indicate pathology. While their coexistence with numerous diseases is well-documented, and various studies have reported their prevalence in populations of various geographic regions, no qualitative critical review of such studies has been conducted. The aim of this paper is to perform a critical review of research studies on the presence of Wormian bones in populations worldwide, with a particular emphasis on the methodology used and the selection of the samples studied. A sample of 44 original research articles was selected via PubMed and Google Scholar databases. Four criteria were assessed: 1) number of individuals in each group, 2) known sex of individuals, 3) selection criteria of individuals, and 4) implementation of the statistical analysis. The origin of the research sample was determined as well as the method of the WB calculation, and data on the WB prevalence worldwide was collected in tabular form. The reported size of the research samples varies from 22 to 628 individuals, derived from both contemporary and archaeological populations. Four major formulas were used in order to provide the frequency of WB. The sex of individuals was known in 18 (40.9%) articles. Most of the articles focused on Asian samples. The difficulties in comparing data on the Wormian bones are caused by considerable inconsistency in the methodology used to research this phenomenon. Therefore, the interpopulation comparisons currently made may not be correctly estimated. Our study highlights the need for using more comprehensive and consistent data collection as well as processing protocol suitable for populational research on sutural bones. [ABSTRACT FROM AUTHOR]

During archaeological excavations in burial sites, sometimes stoned organic objects are found, in addition to human remains. Those objects might be of a different origin, depending on various factors influencing members of a community (i.e. diseases, trauma), which provides information about their living conditions. The St. Nicholas Church archaeological site (Libkovice, Czechia) in the 18th century horizon of the cemetery, yielded a maturus-senilis female skeleton with a stone object in the left iliac fossa. This object was an oviform cyst-like rough structure, measuring 54 mm in length, 35 mm in maximum diameter and 0.2–0.7 mm shell thickness. Within the object there were small fetal bones (long bones, i.e. femur and two tibias, two scapulas, three ribs, vertebrae and other tiny bone fragments). Methods utilized to analyze the outer and inner surface morphology of the cyst and its inside, included: X-ray, CT imaging, SEM, histological staining and EDS. The EDS analysis revealed the presence of primarily oxygen, calcium and phosphorus in bone samples, and oxygen and silicon, in stone shell. Based on the length of the femur (20.2 mm) and tibia (16 mm) shafts, the fetal age was determined as being in the 15–18 week of pregnancy. The differential diagnosis was conducted, including for the three most probable cases: fetiform teratoma (FT), fetus-in-fetu (FIF) and lithopedion. The possibility of fetiform teratoma was discounted due to the presence of an anatomically correct spine, long bones and the proportions of the find. Although the low calcium content in the shell (2.3% atom mass), the lack of skull bones and the better developed lower limbs indicate fetus-in-fetu rather than lithopedion, the analyses results are unable to conclusively identify the object under one of these two categories since there are insufficient such cases in excavation material with which to draw comparison. [ABSTRACT FROM AUTHOR]

In the St. Nicholas Church archaeological site (Libkovice, Czechia; the 18th century cemetery) a female skeleton with a stone object in the left iliac fossa was found. It was a cyst-like structure. The measures of it were 54 mm in length and 35 mm in maximum diameter. Within the object fetal bones (long bones, i.e. femur and two tibias, two scapulas, three ribs, vertebrae and other tiny bone fragments) were revealed. The methods used for the analysis were intended to describe the external and internal morphology of the object and its content: X-ray, CT imaging, SEM, histological staining and EDS. The EDS analysis revealed the presence of primarily oxygen, calcium and phosphorus in bone samples, and oxygen and silicon, in stone shell. The measurements of the femur (20.2 mm) and tibia (16 mm) shafts allowed to estimate the fetal age as the 15-18 week of pregnancy. During the differential diagnosis three most likely cases were taken into account: fetiform teratoma (FT), fetus-in-fetu (FIF) and lithopedion. FT was excluded due to the presence of long bones and their proportions, and due to the presence of an anatomically correct spine. Of the other two possible variants, fetus-in-fetu is more likely than lithopedion, due to the lack of a skull, better development of lower limbs, and low calcium content in the shell. The results do not allow to clearly answer the question which of these two cases is the object due to the insufficient number of similar discoveries in the excavation material. [ABSTRACT FROM AUTHOR]

This work aimed to study the variability in location of the asterion in a Polish population, which may be important for both surgical and anthropological procedures. In surgical approaches to the posterior cranial fossa, the asterion is of great importance as a reference landmark. Its accurate localization may be impeded by the presence of additional, irregular sutural bones. Dry adult human skulls (n = 113, 60.2% male and 39.8% female) were analyzed for asterion location in relation to the reference points ( mastoidale, bregma, porion, inion, lambda, opisthion ). The asterion exhibits wide variation in location. The range of ± 2 SD of measured distances demonstrated broad variation intra and interindividually (15.9-27.8 mm for male skulls and 13.1-24.6 mm for female skulls). Distances from the asterion to the reference landmarks were longer for males compared to females ( p < 0.05), and some distances were longer for people of lower socioeconomic status. Because of its lesser variation, measurements to three reference landmarks ( mastoidale, bregma and frontotemporale ) may be particularly important for surgical purposes. Defining accurately the safe area for asterion is important but problematic. Because of the complex relations between bony landmarks, preoperative imaging assistance is required, and the asterion should only be used as auxiliary, not as a key superficial cranial landmark in surgical interventions.