Row erupts over BBC's use of smartphone images

By Brian Casey, staff writer

June 26, 2019 -- Controversy broke out at the end of last week following a BBC article that used Australian x-rays to support allegations that young adults who used smartphones extensively were growing bony protuberances -- essentially, horns -- on their skulls.

Titled "How modern life is transforming the human skeleton," the 13 June article included several examples of how modern lifestyles have resulted in changes to the human musculoskeletal system -- indicating that "our skeletons are surprisingly malleable." The BBC article dubbed the emerging discipline of studying these changes "osteobiography."

The article included many examples of ways in which the human body is adapting to the modern environment, ranging from the muscular builds of Pacific island tribesmen 400 years ago to narrower elbows on German schoolchildren today.

But the example that has been getting the most attention concerned the growth of "horns" in young adults who are heavy users of smartphones. The BBC article describes a paper published on 20 February 2018 in Nature's Scientific Reports in which Australian researchers discovered a higher prevalence of external occipital protuberances in the skulls of young adults -- bony outgrowths that they documented with radiography.

Example radiographs of two male participants (28 years old and 58 years old) presenting with large enthesophytes emanating from the occipital squama
Example radiographs of two male participants (28 years old and 58 years old) presenting with large enthesophytes emanating from the occipital squama. These images also include the enthesophyte measurements used throughout this study. Image courtesy of David Shahar and Mark Sayers. Licensed under CC BY 4.0.

The researchers postulated that the protuberances were caused by heavy use of handheld devices, which led to "aberrant" postures as users bent down to look at their smartphones and tablets. Such postures caused excess load on tissue, which resulted in the formation of enthesophytes, abnormal bony projections at the attachment of a tendon or ligament.

The development of enthesophytes could be an adaptive mechanism by the body to increase the surface area at a location that's experiencing frequent tensile stress, with bone growth progression occurring at the site, the authors speculated.

In their 2018 paper, David Shahar, PhD, and Mark Sayers, PhD, of the University of the Sunshine Coast examined the prevalence of enlarged external occipital protuberance (larger than 10 mm) in a population of 1,200 individuals ages 18 to 86. They found that male sex, younger age, and a higher degree of forward head protraction were positive links to the development of the protuberances.

What's more, Shahar and Sayers recorded an increase in forward head protraction in their current sample compared with 1996, a change they attributed to the "handheld technological revolution."

"We hypothesize that the use of modern technologies and handheld devices may be primarily responsible for these postures and subsequent development of adaptive robust cranial features in our sample," the team wrote.

In an interview with the BBC for last week's article, Shahar said he had been a clinician for the past 20 years and has only begun noticing the skull growths in the last decade.

However, at least one radiologist, Dr. Wende Gibbs of the Mayo Clinic in Phoenix, wasn't so sure the findings were that notable, in particular the way the study was covered in the Washington Post.

Copyright © 2019

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