Reports of Legg-Calvé-Perthes disease (LCPD) in the paleopathological literature are rare. Here, the authors present a probable case of LCPD, which presents as abnormal morphology of the proximal femur. The condition was observed in an individual of the Warring States period in Shaanxi Province, China, and the morphology involves a "mushroom head" deformity of the proximal right femur and an enlarged acetabulum, along with a contralateral tibia, talus, and navicular that are enlarged and demonstrate periosteal new bone formation. The authors consider tuberculosis, septic arthritis, trauma, slipped capital femoral epiphysis, and Legg-Calvé-Perthes disease in a differential diagnosis. The authors conclude that the most likely diagnosis for the deformity is Legg-Calvé-Perthes disease. Bony changes in the hip joint and contralateral lower leg suggest that the individual had an altered gait because of the condition.

A human skull, buried about 2500 years ago in a Bronze Age cemetery at Jinggouzi, a site of an important ethnic group in ancient China, appeared to have characteristics of fibrous dysplasia. The CT images indicated a reduction in bone density and relatively homogeneous lesions. More features were revealed using CT reconstruction techniques. Lesions seen in low-magnification images using a 3D deep-field microscope had an irregular honeycomb-like structure. At higher magnification, the trabeculae morphology and the gaps between the trabeculae were irregular and varied in size and shape. Paraffin-embedded specimens stained with HE showed trabeculae with tortuous irregular arrangements varying in shape and width. The irregular trabeculae of woven bone has been described as having fibrous dysplasia. Molecular analysis of the GNAS gene indicated no mutation. This provides a non-invasive approach for us to make more comprehensive diagnoses and to assist research into ancient human diseases.