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A blow to a vital part could cause this, especially if the victim suffered from fatty degeneration of the heart.
Several possible hypotheses for explanation of the pathogenesis of steroid-induced osteonecrosis, including increased size and number of fatty cells, increased intra osseous pressure, fatty degeneration of osteocytes, fat embolism and extra osseous arterial occlusion have been proposed in the literature (5).
5) The findings of Goutallier et al similarly support that increased wait times lead to increased fatty degeneration of the torn rotator cuff muscle.
Pathologist Dr Michael Curtis said minor blunt force trauma could cause this as Mr Jaskelevicius had fatty degeneration of the liver due to alcohol abuse which would also have added to bleeding.