Published online before print January 24, 2003, 10.1148/radiol.2263020338
The Iceman: Discovery and Imaging1
William A. Murphy, Jr, MD,
Dieter zur Nedden, MD,
Paul Gostner, MD,
Rudolf Knapp, MD,
Wolfgang Recheis, PhD and
Horst Seidler, PhD
1 From the Division of Diagnostic Imaging, Box 057, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 (W.A.M.); Department of Radiology II, University of Innsbruck, Austria (D.z.N., W.R.); Department of Radiology, Regional General Hospital, Bolzano, Italy (P.G.); Department of Radiology, Kufstein Hospital, Kufstein, Austria (R.K.); and Institute for Human Biology, University of Vienna, Austria (H.S.). From the 1994 RSNA scientific assembly. Received March 25, 2002; revision requested June 10; revision received July 26; accepted August 1. Address correspondence to W.A.M. (e-mail: wmurphy@di.mdacc.tmc.edu).
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Figure 1. Frontal photograph of the iceman (obtained in September 1991) shows dry contracted skin resulting from the natural mummification process. The eyeballs are completely collapsed because of dehydration. The upper lip is deformed, and the nose is flattened secondary to lying in the prone position and probably bearing the weight of ice and snow.
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Figure 2. Radiograph shows variable shrinkage of the brain. Frontal view of the head (obtained on May 25, 1993, with the body in the supine position) shows the shrunken brain surrounded by dura mater (arrows) that did not shrink as much as the brain did. Note the falx cerebri (arrowheads) within the interhemispheric fissure. The brain exhibits variable opacity, probably due to variation in the physical and chemical alterations that accompanied an intermittent or inhomogeneous mummification process.
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Figure 3. Transverse CT section through the orbits and foramen magnum (obtained on September 25, 1991) shows examples of multiple hairline fractures (arrows) in the facial bones and at the skull base. The fractures are consistent with the combined effects of freezing and thawing cycles and the weight of ice and snow. Note the thick frontal bone (arrowheads) and prominent supraorbital ridge.
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Figure 4. Photograph of the iceman’s mouth (obtained in September 1991) shows diastema (widely spaced central incisors, arrow). Shrinkage and deformation of the lips are due to dehydration and pressure from external forces. There is retraction of the gums around the maxillary teeth, and portions of the roots are exposed. Note the flattened surfaces of the incisors and canines, attributed to wear.
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Figure 5. Transverse CT section through the maxillary teeth (obtained on September 25, 1991) shows 14 teeth and bilaterally absent third molars. Note the diastema (arrowhead) and the dehydrated tongue (arrows).
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Figure 6. Detail of the teeth from a lateral radiograph of the skull (obtained on May 25, 1993) shows that all teeth are worn and flattened, presumably from mechanisms of wear specific to the lifestyle of the iceman. Note absence of third molars (X = expected molar positions).
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Figure 7. Photograph of the mummy’s chest and abdomen (obtained in September 1991) dramatically illustrates the severity of dehydration and anterior thoracic collapse. The ribs have rotated in a caudal direction and are pressed against the spine, as is the sternum. The left arm is extended across the chest and is held in that position by the brittle dehydrated and frozen tissues.
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Figure 8. Frontal radiograph of the chest and upper abdomen (obtained on May 25, 1993) confirms the caudal rotation of the ribs and shows the folded soft tissues at the thoracolumbar junction (compare with Fig 7). Only 11 rib-bearing thoracic vertebrae are present. The usual shadows of the heart, pulmonary vessels, and lungs are absent because of severe shrinkage of these organs. The fracture (arrow) of the left humerus was acquired during the recovery effort.
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Figure 9. Transverse CT section through the thorax (obtained on May 3, 1994) confirms the compressed anteroposterior diameter of the thorax and displays the right-angle deformity (arrowhead) of the rib cage that was acquired as the corpse adjusted to the changing forces brought about by progressive dehydration and increasing pressure from the weight of snow and ice. The wafer-thin heart (*) is sandwiched between the juxtaposed sternum and spine. The dehydrated lungs (arrows) are only wisps of tissue.
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Figure 10. Detail of the left side of the rib cage from a frontal computed radiograph of the iceman’s chest (obtained on May 25, 1993) shows several well-healed rib fractures. The most conspicuous fracture is in the eighth rib (arrow). The multiple healed fractures indicate that the iceman survived one or more serious injuries during his life.
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Figure 11. Photograph of the posterior aspect of the iceman’s pelvis and thighs (obtained in September 1991) demonstrates dehydration and shows the extensive left pelvic injury acquired as the body was recovered from the ice. The various tools used to break up the ice chipped much frozen soft tissue and some bone away. The left hip is disarticulated, as manifested by the exposed left femoral head (arrow).
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Figure 12. Detail of the right hip joint from a transverse CT section (obtained on May 3, 1994) shows evidence of osteoarthritis, as manifested by proliferative bone (arrows), osteosclerosis, and small round subarticular lucent areas. True joint space width cannot be determined because dehydration of the hyaline articular cartilage caused artificial narrowing.
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Figure 13. Frontal digital computed radiograph of the head and chest (obtained on September 25, 1991) acquired as a scout image in preparation for CT of the head and thorax shows the left humeral fracture (arrow) acquired when the completely recovered corpse was forcefully placed into a wooden box for transportation from the mountain by helicopter. Because the fixed position of the left arm extended across the chest prevented the body from complete enclosure in the coffin (the left arm and hand extended well beyond the right side of the mummy), a reduction of the unusual position was attempted. Because the shoulder was stiff and frozen, the force applied to the forearm caused the humerus to snap.
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Figure 14. Anteroposterior radiograph of the distal right forearm (obtained on May 25, 1993) shows injury from an instrument with a sharp tip. Linear bone shards (arrows) were chipped away from the ulnar aspect of the radial cortex. The presumption is that an ice pick used to break up ice during the recovery effort inadvertently penetrated the arm.
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Figure 15. Transverse CT section through the diaphysis of the right tibia and fibula (obtained on May 3, 1994) shows thick cortices, a well-developed nutrient canal (arrow), and an elongated anteroposterior diameter of the bones, also present on the left side. It is surmised that this configurational oddity indicates a biomechanical adaptation to the requirements of life and labor on the slopes of the Alps. The cracked tibia (arrowheads) is attributed to trauma acquired during the recovery effort.
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Figure 16. Detail of the distal right tibia from an anteroposterior computed radiograph of the right leg (obtained on May 25, 1993) shows several horizontal Harris lines (arrows) in the dimetaphyseal cancellous bone.
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Figure 17. Detail of the left little toe from an anteroposterior radiograph of the foot (obtained on May 25, 1993) shows a degenerative arthritic appearance of the proximal interphalangeal joint, manifested by sclerosis and spur formation (white arrow) at the base of the middle phalanx and a subarticular lucent area (black arrow) with minimal sclerosis at the head of the proximal phalanx. It is surmised that this lone abnormality of the digits represents healed frostbite.
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Figure 18a. Marrow air distribution changes with time. (a) Transverse CT section through the left calcaneus (obtained on September 26, 1991) shows generally homogeneous water attenuation in cancellous marrow. Several small collections of air (arrows) are present in the marrow. Air is also present in soft-tissue planes and spaces. (b) Transverse CT section through the left calcaneus (obtained on May 3, 1994) more than 2 years later shows a different marrow appearance, with much more air (*) in the calcaneal marrow space. Note a similar change in the talus and the soft tissues. It is postulated that the bones of the feet partially thawed in the interval. Air replaced marrow water that drained from portions of the marrow space.
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Figure 18b. Marrow air distribution changes with time. (a) Transverse CT section through the left calcaneus (obtained on September 26, 1991) shows generally homogeneous water attenuation in cancellous marrow. Several small collections of air (arrows) are present in the marrow. Air is also present in soft-tissue planes and spaces. (b) Transverse CT section through the left calcaneus (obtained on May 3, 1994) more than 2 years later shows a different marrow appearance, with much more air (*) in the calcaneal marrow space. Note a similar change in the talus and the soft tissues. It is postulated that the bones of the feet partially thawed in the interval. Air replaced marrow water that drained from portions of the marrow space.
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Figure 19. Transverse CT section through the upper abdomen (obtained on September 25, 1991) shows dehydration and severe shrinkage of the liver (arrows) and other organs. Only the transverse colon (*) has a reasonably normal shape. Stool from a prior meal(s) is present.
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Figure 20. Transverse CT section through the lower abdomen (obtained on May 3, 1994) shows a linear calcification (arrow) closely juxtaposed to the anterior cortex of the transitional vertebral body. We interpreted this feature as calcification in the aorta, now collapsed following desiccation.
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Figure 21. Irregular opacity (arrows) in the left shoulder retrospectively detected on a conventional frontal radiograph of the chest (obtained on September 26, 1991) has the general configuration of an arrowhead. Also in retrospect, the arrowhead is visible on the radiograph obtained on May 25, 1993 (Fig 8).
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Figure 22. Transverse CT section through the shoulder region (obtained on September 25, 1991) shows a fusiform opacity (arrows), later shown to be an arrowhead lodged between the ribs and the left scapula.
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Figure 23. Transverse CT section (obtained on May 3, 1994) through the left shoulder region (caudal to the prehistoric arrowhead) shows an inhomogeneous area of attenuation (dehydrated hematoma, arrow) between the lateral rib cage and the scapula. Note the discontinuity in the ossified body of the scapula and the wispy soft-tissue opacity (hematoma) that extends through the bone defect (arrowheads). We speculate that the arrowhead and a portion of the arrow shaft penetrated the scapula in this location and that blood from the deep hematoma followed the arrow track into the subcutaneous tissues.
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Figure 24. Anatomic variants discovered in the iceman.
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Copyright © 2003 by the Radiological Society of North America.
