Palaeopathology

Abstract

Palaeopathology is designed to help bone specialists with diagnosis of diseases in skeletal assemblages. It suggests an innovative method of arriving at a diagnosis in the skeleton by applying what are referred to as 'operational definitions'. The aim is to ensure that all those who study bones will use the same criteria for diagnosing disease, which will enable valid comparisons to be made between studies. This book is based on modern clinical knowledge and provides background information so that those who read it will understand the natural history of bone diseases, and this will enable them to draw reliable conclusions from their observations. Details of bone metabolism and the fundamentals of basic pathology are also provided, as well as a comprehensive and up-to-date bibliography. A short chapter on epidemiology provides information on how best to analyze and present the results of a study of human remains.

A Case of Gout from Imperial Rome (1st-2nd Century AD)

“…As in this case, cancer cells destroy the spongy and cortical bone with osteolytic lesions, but differently from the examined subject, erosions preferably affect the large bones that are richer in hematopoietic marrow: the axial skeleton, femur, and skull [4,6].…”

“…RA involves many joints and the earliest lesions occur symmetrically in the hands causing deformities, in particular in the metacarpal-phalangeal and interphalangeal joints. Other commonly affected districts are the feet, knees, elbows, wrists and shoulders [4,6].…”

“…Compatible alterations with the examined subject may also be due to gout, a metabolic disease characterized by hyperuricemia: the abnormal accumulation of uric acid in the blood that causes the precipitation of uric acid crystals either within or around a joint, inducing erosion of bone and cartilage and resulting in a destructive, chronic and disabling arthritis [4,12]. Gout often involves many joints and the most commonly affected sites are the foot, in particular the tarso-metatarsal and metatarso-phalangeal joints, ankle, knee, hand and wrist.…”

“…Differential diagnosis suggests that this individual was affected by gout, probably associated with hypothyroidism that determined her short stature. In the lower limbs, the knee joints were affected by degenerative alterations: the articular surface of the right femoral condyles was affected by a lytic lesion with erosion of the subchondral bone, diagnosed as osteochondritis dissecans, an osteochondral microfracture-caused by direct trauma or repetitive microtraumas-which is commonly the consequence of vigorous physical activities [4].…”

Examining Reactive Arthropathy in Military Skeletal Assemblages: A Pilot Study Using the Mass Grave Assemblage from the Battle of Towton (1461)

“…The key features examined for age estimation in this study were: epiphyseal fusion (only an option in young adults, based on McKern and Stewart 1957), dental attrition (compared to Brothwell 1981), changes to the pubic symphysis (using Brooks and Suchey 1990), and changes to the auricular surface of the pelvis (using Lovejoy et al 1985). After comparing the ages assigned by the various methods, individuals were placed into one of four potential categorizations based on ten year increments, which were: Young Adult (16-25), Lower Middle Adult Arriaza 1993;Blondiaux et al 1997;Hacking et al 1994;Inoue et al 2005;Inoue et al 1999;Martin-Dupont et al 2006;Mckinnon et al 2013;Rogers et al 1991;Rothschild et al 1999;Rothschild et al 1990;Rothschild and Heathcote, 1995;Rothschild and Woods 1991;Šlaus et al 2012;Tersigni-Tarrant and Zachow 2010;Waldron 2009;Waldron et al 1994;Waldron and Rogers 1990;Zias and Mitchell 1996). Source: created by author.…”