It looks to me like that Roman was extremely hypermobile in this picture.
And it appears to me, IMHO, that he may have had a connective tissue disorder (CTD). Perhaps even a vascular type of a CTD. Which if this diagnosis isn’t caught/diagnosed before the age of approximately 20 the mortality rate is almost inevitable. Unfortunately.
IMO this potential diagnosis explains his extensive bruising as well as his facial characteristics appearance; e.g. thin lips, small chin, thin nose, large eyes.
The potential vascular CTD diagnosis would also explain why a pathologist is working on/needed for this case & NOT a toxicologist.
And I say all of this bc I too have a genetic connective tissue disorder that causes extensive, long lasting bruising as well as chronic dislocations & subluxations (partial dislocations), fragile/stretchy skin that heals VERY slowly from all injuries & wounds & very fragile organs. As well as many other awful things....yay said by no one with a g-CTD ever.
People with CTDs don’t necessarily have autism. In fact most of them don’t. In the last 5 generations in my family who has this genetic defective/faulty collagen disorder only 3 of us were/are on the spectrum (3 out of dozens & dozens of us, if not hundreds...it’s very late & I can barely keep my eyes open, let alone just think of all of my distant relatives who have this genetic disorder...which also means I won’t be able to correct my grammar, punctuation or spelling. Which I sincerely apologize for right now.
..)
I am definitely NOT saying that he wasn’t abused nor am I saying that he was abused.
All I am saying is that not everything is as it seems.
PS: If this potential idea of a genetic CTD has already been discussed, please feel free to delete. I haven’t read the entire thread yet.