Evaluation and interpretation of residual rickets deformities in adults

Recent research has considerably improved the recognition and recording of rickets and osteomalacia in archaeological human bone, but the recognition and recording of residual deformities of rickets present in adults is still limited. The aim of this study was to assist with differential diagnosis of residual rickets deformities and determine which of the deformities that are characteristic of rickets could be identified in the adult skeleton. Long bone deformities were investigated, with research focusing on deformities of the leg bones. One hundred and thirty‐five adults from the historic cemetery of St Martin's, Birmingham, where vitamin D deficiency was known to have been widespread, were analysed. Deformities of leg bones were three times as frequent as arm bone deformities, and deformity of both the femur and tibia was the most frequently recorded combination of leg bones. Medial bending of the tibiae and anterior bending of femora, both at the proximal end, were the most frequently recorded types of deformities. A review of a range of conditions that can cause bowing deformities, and comparison of bowing recorded in children with rickets and the present cases, concluded that the most likely cause of the deformities recorded was residual changes linked to rickets. In this community, bowing deformities linked to rickets were quite common amongst adults and probably did not have adverse social consequences, but further studies are required to determine whether this attitude to deformity was more widespread. Copyright © 2008 John Wiley & Sons, Ltd.     

Residual rickets or osteomalacia: a case dating from the 16–18th centuries from Krosno Odrzańskie,Poland

A skeleton from a 16–18^th century burial site in Krosno Odrzańskie, Poland, was examined using classical morphological, metric and macroscopic palaeopathological observations, as well as radiography and tomography of the skull and long bones. A wide variety of the observed bone deformations probably occurred as a consequence of past rickets and/or osteomalacia, whose primary cause may also have been chronic renal failure. Preservation of the bones enables a discussion of the cause of such pathological changes. The subject under study appears to be a very interesting example of an individual whose skeleton shows advanced pathological alterations associated with the subject's vitamin D deficiency, overall health conditions and relatively long lifespan. Copyright © 2008 John Wiley & Sons, Ltd.     

Dry-bone manifestations of rickets in infancy and early childhood

Rickets and osteomalacia are the subadult and adult expressions of a disease in which the underlying problem is a failure to mineralize bone protein (osteoid). The most common cause of this disease is a physiological deficiency in vitamin D. The associated problems include deformed bones and this condition is well known in pre-modern medical texts and documents as a fairly common cause of morbidity. Given these facts, it is surprising that the literature on palaeopathology provides very little evidence of this disease in archaeological human skeletal samples. The medieval sample (N=687) of human remains from Wharram Percy, North Yorkshire, England contains a remarkable subsample of eight burials in which a spectrum of pathological features is expressed. The subsample includes infants ranging in age from 3 to 18 months at the time of death. Ten abnormal bone features were identified in the subsample, including: (i) cranial vault porosity; (ii) orbital roof porosity; (iii) deformation of the mandibular ramus; (iv) deformation of arm bones; (v) deformation of leg bones; (vi) flared costo-chondral ends of ribs; (vii) irregular and porous cortex of the costo-chondral ends of the ribs; (viii) abnormality of the growth plates of long bones; (ix) irregular and porous surfaces of the metaphyseal cortex; (x) thickening of the long bones, particularly in the metaphyseal areas. Not all of these features were found in all of the cases. Nevertheless, the overall pattern of skeletal abnormality fits well with the anatomical and radiological conditions associated with rickets. © 1998 John Wiley & Sons, Ltd.     

Metastatic carcinoma in a leper skeleton from a Medieval cemetery in Chichester England

Both leprosy and metastatic cancer are well documented in the literature on human skeletal palaeopathology. The manifestation of both pathological conditions in a single archaeological skeleton has not been reported. A case from a Medieval site in Chichester, England exhibits bone lesions and patterns of skeletal involvement indicative of both these diseases. Evidence of leprosy is largely restricted to the lower tibiae, fibulae and the bones of the feet. Fine destructive foci and reactive fibre bone associated with metastatic cancer are distributed in many of the remaining areas of the skeleton. There is minimal overlap in the areas of the skeleton involved in the two pathological processes.     

Bone weight: new reference values based on a modern Portuguese identified skeletal collection

Skeletal weight and/or weight of the different bones of the human skeleton are currently used in a wide range of applications such as archaeological cremations and forensics. Still, few reference values are available that compare the mean weights for the different skeletal parts. In this paper we present new reference values for total skeletal weight, including the weight of the different skeletal bones based on a modern Portuguese Identified Skeletal Collection (CEI) curated in the Museum of Anthropology of the University of Coimbra (Portugal). The mean weight of the entire skeleton for the CEI pooled sample is 3323.8 ± 779.6 g. Sex and age differences were investigated. As expected, males display heavier bones, at a statistically significant level. The mean weight of the male skeletons is 3850 g, and 2797.6 g for the female sample. Age differences were found, especially for the female samples in the 29–39 versus 50–59 and/or >60 age groups, probably as a consequence of age‐related bone loss in post‐menopausal women. For the male sample, no clear age‐related trend was observed but for the unexpected result that the second highest bone weight recorded is in the oldest age group (>60 years). This could result from high mechanical loadings and thus greater bone robusticy and amount of cortical bone. The percentage of weight of the different parts of the skeleton was also calculated. These new values can be quite useful in the study of very fragmentary and/or commingled human remains, recovered from historic or forensic contexts, since the complete identification, by side, of the remains is not necessary. Copyright © 2008 John Wiley & Sons, Ltd.     

Rickets in a High Social Class of Renaissance Italy: The Medici Children

Exploration of the Medici Chapels in the Basilica of San Lorenzo in Florence revealed the burials of nine juvenile members of the Medici family (16th–17th centuries). The estimated children's skeletal ages ranged from newborns to 5‐year‐olds, showing a series of bone abnormalities, in particular diffuse periosteal new bone and bowing of long bones. The comparable pathological lesions, including porosity evident on the skull, orbital roofs, costocondral ribs and growth plates between metaphyses and epiphyses, enlargement of metaphyses and sternal rib ends, and long bone bending, are interpreted as the skeletal manifestation of rickets. The diagnosis of a metabolic disease linked to vitamin D deficiency would appear to be unexpected for children brought up at the court of a Renaissance elite class family like the Medici of Florence. Analysis of the historical and social background is particularly helpful to understand the causes of the onset of the disease in this aristocratic group. Documentary sources, supported by ¹³C and ¹⁵N bone collagen analysis, attest that weaning of these children took place when they were around 2 years old. With a prolonged breast‐feeding and a delay in introducing solid food in the diet, vitamin D deficiency is expected to rise considerably, in particular if the other main risk factor, namely inadequate sunlight exposition, is associated with this human milk‐based diet. Copyright © 2013 John Wiley & Sons, Ltd.     

Variable nucleotide tandem repeat (VNTR) typing of two palaeopathological cases of lepromatous leprosy from Mediaeval England

Using ancient DNA methods, we have examined in detail two archaeological cases of leprosy from Mediaeval England. The first was a child skeleton with rhino-maxillary changes typical of lepromatous leprosy (LL). The second case was the skeleton of a male adult who showed both typical rhino-maxillary changes and osteitis/periostitis on the leg and foot bones. Bone powder was sampled from both cases and DNA extracts were prepared. These were subjected to a series of polymerase chain reactions (PCRs) specific for regions on the Mycobacterium leprae genome. The repetitive element RLEP was used for confirmation of M. leprae DNA and then three polymorphic regions were successfully amplified and sequenced to determine the number of variable nucleotide tandem repeats (vntr) at these loci. These were the microsatellite regions ML2344 and ML2172 and the minisatellite region ML0058. Genotyping data from the strains preserved within the skeletal remains were compared with those obtained for a reference strain of M. leprae. Variation at these three loci was found between both burials and the reference strain, indicating that vntr typing of LL cases from the archaeological record is a useful way of confirming disease and an additional means of authenticating aDNA data. This demonstrates the feasibility of targeting multiple loci for phylogenetic studies of leprosy strains from archival sources.     

Rib fractures in the archaeological record: a useful source of sociocultural information?

Investigation of palaeopathological fractures has been shown to provide important information on past societies. However, despite the fact that rib fractures are amongst the most commonly recorded types of fractures in archaeological bone, little attention has been paid to them. Although there will be sites with badly preserved ribs, making their study difficult, this will not always be the case. Recent clinical investigations have highlighted the potential significance of rib fractures with regard to morbidity and mortality, and their importance in relation to health is now appreciated. This study investigates rib fractures in 352 adults from St. Martin's churchyard, Birmingham, England. The crude prevalence of rib fractures was found to be 15.6% and the true prevalence rate 2.3%. The majority of the fractures occurred in males, and those buried in vaults were less likely to have a fracture than individuals from earth‐cut graves. In 11 individuals the fractures were healing at the time of death, and in these cases death was probably related to one of the complications that are frequently linked to fractured ribs. Certain types of accidents may have been linked to these more serious fractures, as 70% occurred in the same anatomical area. Other rib fractures were associated with pathological conditions, such as osteomalacia and osteoporosis. Overall, the study of the rib fractures in this collection provided valuable information that aided interpretation of the lifeways of individuals investigated. It is argued that where preservation permits, studies of fractures in archaeological bone should include ribs. Copyright © 2005 John Wiley & Sons, Ltd.     

Experimental effects of bone size and temperature on bone diagenesis

In the ground, bone undergoes chemical and physical changes which affect its preservation. This fact has important implications for dating and other analytical procedures involving bone, as well as faunal analysis where differential preservation of bones of different species may affect conclusions regarding the relative significance of an animal to the economy of a given society. The diagenic processes in bone range from minor changes in the bone protein to complete structural and chemical breakdown.Using fresh cow bone, we conducted laboratory experiments which simulate the effect of temperature and bone size on the rate and nature of bone disintegration in archaeological sites. Temperature influences the rate of chemical change, and bone size and density affect the accessibility of the molecular constituents of bone to extrinsic chemical reactions. These findings clarify the importance of two well-known concepts in bone taphonomy. (1) The rate of chemical breakdown in bone tissues is related to the proximity of a given unit of tissue to the bone surface. This means that, in archaeological bone samples, tissue near the surface may be different chemically from tissue away from the surface and great care is necessary in choosing and preparing bone samples for analytical procedures. (2) In general, small bones are not as well preserved as large bones, therefore small animals are likely to be underrepresented in faunal assemblages.     

Bone survival: The effects of sedimentary abrasion and trampling on fresh and cooked bone

It is commonly assumed that, at least when considering similar sized animals, the bones from all taxa stand an equal chance of preservation. This paper summarizes one aspect of a larger study undertaken in order to assess whether this assumption is true, based on the results of experiments and observations into the effects of a range of pre-depositional processes. The rates of bone destruction by sedimentary abrasion and by trampling are determined for small mammal, fish and frog bones. Patterns of bone loss and fragmentation are examined both between species and within the skeleton, for fresh and boiled bone. It is shown that there is considerable interspecies variation in the ability of bones to withstand these physical forces. Frog bone proved particularly resistant, while within the fish, bone from the Gadidae was less resilient than might be expected, given its predominance in British Medieval archaeological sites and coastal sites of all periods. Within the skeleton, bone shape appears to be a very important determinant of relative survival. Boiling dramatically reduces bone's resistence to destruction. The physical properties of fresh, boiled and burnt bone are compared mechanically, and the dramatic loss of strength induced by heating is demonstrated. The often voiced assumption that fish bone is more prone to destruction than mammal bone is shown to have some validity. The results add more evidence to support the view that comparison of species abundance by fragment counts may not always be appropriate, and that interpretation of skeletal element frequencies should be approached with caution.     

Túnel: A Case Study of Avian Zooarchaeology and Taphonomy

Although not often considered, there are many osteological characters unique to the avian skeleton that influence the taphonomy of bird bones. These characters are reviewed and their archaeological significance discussed herein. The presence of marrow in many avian long bones is important to interpretation of avian remains from archaeological sites because the presence of marrow affects bone density and, in turn, preservation. Other structural properties that affect avian bone preservation include cortical wall thickness, length and pneumatic state. Based on an analysis of approximately 10,000 bird bones from the archaeological site of Túnel, Tierra del Fuego, Argentina, I found that specific breakage patterns resulted from natural taphonomic processes acting as a result of the unique avian bone characteristics. This information may allow researchers to distinguish breakage patterns in avian bones resulting from natural taphonomic processes from breakage patterns that are culturally induced.     

An assessment of the value of bone density measurements to archaeoichthyological studies

This paper reviews the meaning of the term ‘density’ and the problems associated with the methods of density determination for animal bones in archaeology. It has often been assumed that density is the intrinsic property of most influence in controlling the rate of a bone's decay. Values for whole bone density have been published only for large mammal bone, however. Fish bone appears to be particularly vulnerable to decay, and usually a restricted range of skeletal elements are recovered from archaeological sites. The object of this study was to examine the relationship between fish bone density and the ability of the bone to survive on occupation sites and in archaeological deposits. A set of ‘density’ measurements was established for the bones of cod (Gadus morhua). The usefulness of these measurements as a predictive tool in archaeoichthyological studies is assessed. It was found that ‘density’ as measured did not explain adequately the relative survival of skeletal elements after mechanical abrasion and weathering, or within archaeological deposits.     

Multicentric osteosarcoma associated with DISH,in a 19th century burial from England

Osteosarcoma is a rare type of malignant neoplasm that is most frequent in adolescents and young adults although it can develop at any age. It can metastasize from a primary site in bone to other bones and soft tissues. Usually the disorder causes a single bone‐forming lesion (unicentric) but some cases have multicentric, bone‐forming lesions. Some of these lesions develop at different sites at different times. In a second variant of multicentric osteosarcoma, synchronous bone‐forming lesions develop at multiple sites. Distinguishing between these two types of multicentric osteosarcoma is challenging in a clinical context and the criteria for doing so are unlikely to be met in an archaeological burial. Wolverhampton burial HB 39 was excavated from an early‐nineteenth century cemetery site in England. It consists of the incomplete skeleton of an adult male of at least 45 years of age with multicentric osteosarcoma. The individual represented by this burial also had diffuse idiopathic skeletal hyperostosis (DISH). Three of the bone‐forming lesions associated with osteosarcoma developed on the bony outgrowths related to DISH. Copyright © 2010 John Wiley & Sons, Ltd.     

A Large‐Scale Palaeopathological Study of Hip Fractures from Post‐Medieval Urban England

Hip fractures have high incidence rates in many current groups and are associated with high morbidity, mortality, and considerable expenditure. Although hip fractures associated with significant traumatic events can occur at any age, many hip fractures occur in older adults. To date, few hip fractures have been reported from archaeological skeletal material, and a number of hypotheses have been suggested for this. This research presents a comprehensive assessment of hip fractures in archaeological bone; 1597 adult (18+ years) skeletons from eight urban post‐medieval sites from England dating from the 18^th and 19^th centuries were recorded, and contemporary medical texts reviewed. This adult sample included 834 males and 652 females as well as 11 persons of undetermined sex. Ways of classifying and describing fractures in the clinical literature were reviewed and a methodology applicable to paleopathology determined. Of this sample, 15 (0.94%) had fractures in the femoral neck or intertrochanteric area: nine males, four females, and two individuals of undetermined sex. The numbers of fractures in males were interesting and most likely represent examples of accidental trauma as well as osteoporosis‐related fractures, the latter receiving growing awareness in recent clinical literature. Overall there was an age‐related trend with more individuals aged 50+ years with fractures than in other age categories. Underlying osteoporosis was potentially a complicating factor in five individuals and was likely associated with a vitamin D deficiency osteomalacia and a metastatic neoplastic condition in a further two cases. Fractures occurring close to the time of death and healed fractures were observed, indicating that the risk of mortality following this trauma was not consistent across this 18^th and 19^th century sample. Skeletal and historical evidence presented in this study indicate that the impact of hip fracture injuries varied, with survival likely linked to the fracture type. Copyright © 2016 John Wiley & Sons, Ltd.     

Animal palaeopathology: Possibilities and problems

A brief account of the range of pathological disorders affecting the skeleton and certain other tissues of animals (mainly mammals) is given to indicate a broad picture of the sort of lesions which might be encountered in archaeological contexts.Though palaeopathological bone specimens have been described since the 18th century, it is only recently that an interest in archaeozoological material has encouraged the tentative interpretation of such specimens. Despite the pessimism of some workers in the field, it has been shown that this material does persist in archaeological samples, and that while diagnosis is not always clear cut, some of the spectrum of bone changes induced by disease processes has been documented.As early as 4000 years ago an awareness of some of these diseases was recorded, with several early societies adopting preventive and therapeutic measures to deal with them. As advanced human communities came into more intimate contact with animals, transmission of infectious diseases was facilitated. Husbandry practices, too, are seen to be directly related to the incidence of certain conditions, the occurrence of which in archaeological material can yield an insight into animal keeping.Diverse data of archaeological significance is, in fact, retrievable not only from osteological remains, but from organic material which may be preserved under certain conditions. The impact of animal disease is far-reaching, with important implications not only for the economy but also for human health.     

Traumatic bowing deformities in tubular bones

Is bowing in long bones from an archaeological context representative of postmortem damage or genuine antemortem pathology? Bowing deformities (also known as traumatic bowing deformities, plastic bowing deformities, plastic bowing fractures and acute bowing fractures in the clinical literature) are true pathological entities that have only recently been recognized by clinicians. Bowing in long bones results from a force that exceeds the elastic properties of a given bone, producing a new plastic (bowing) response phase. These subtle deformities commonly affect the radii and ulnae in children and less frequently other tubular bones of the skeleton. Traumatic bowing should be considered as a possible diagnosis whenever abnormal curvature of a long bone is observed. This presentation illustrates two cases of traumatic bowing isolated from two ossuary populations from Ontario, Canada and addresses differential diagnostic concerns. © 1998 John Wiley & Sons, Ltd.     

Experimental chemical degradation compared to natural diagenetic alteration of collagen: implications for collagen quality indicators for stable isotope analysis

Stable isotopic ratios from archaeological bone collagen are valid palaeodietary indicators, but depend on sufficiently well preserved molecules and several collagen quality criteria have to be fulfilled (mostly collagen wt%, C%; N%, C/N molar ratio). For a reassessment of these quality criteria, and a better understanding of the chemical degradation of bone collagen, experimentally degraded modern bones and 54 archaeological human bones were investigated. In the course of the experimental degradation, alterations of isotopic ratios were paralleled by altered collagen quality criteria. The contrary was found in the case of the archaeological specimens. This implies that the commonly used collagen quality criteria may be insufficient and do not guarantee that stable isotopic values of the gelatine extracts will still represent the original biological signal.     

Virtual skeletons: using a structured light scanner to create a 3D faunal comparative collection

Appropriate comparative animal skeletons are not always available to faunal analysts for use in identifying archaeofaunal remains. This is especially pertinent when working in locations where no comparative collections are available locally, and the archaeological assemblage cannot be transported to another facility. In order to fill this gap, we are building a virtual comparative faunal collection using a structured light scanner to scan modern skeletal material in 3D. The resulting high resolution 3D color models are a valuable resource for identifying fossil specimens. Scan data can be converted into a variety of formats for viewing and can be transported on a portable digital device for use at field or laboratory localities. In addition, scans can be printed three dimensionally to produce a replica of the scanned skeletal part. A particular advantage of this digital technology is that we can eventually create a complete 3D representation of a taxon's skeleton from scans of several components of what are incomplete skeletons of one animal taxon in a museum collection. The results of our project thus far are available to other researchers and educators by means of the internet. A variety of interested parties could benefit from such a collection, including zooarchaeologists, paleontologists, biologists, teachers and museum curators.     

Identifying bilateral pairs of deer (Odocoileus sp.) bones: how symmetrical is symmetrical enough?

Identifying bilaterally paired bones in zooarchaeological collections rests on the assumption that left and right skeletal elements from the same organism will be symmetrical. Bilaterally paired bones in an individual are, however, typically asymmetrical to some degree, demanding that the question “How symmetrical is symmetrical enough to identify a bilateral pair?” be answered with control data. The degree of symmetry chosen, or tolerance, will influence both how many true pairs in an archaeological collection are not identified (type I error) and how many false pairs are identified (type II error). Bivariate measures of 60 pairs of astragali and 48 pairs of distal humeri of deer (Odocoileus virginianus and O. hemionus) indicate that both sorts of error are frequent even when a conservative level of tolerance (≤average asymmetry) is used. Simulation of an archaeological collection indicates that as sample size increases, frequencies of both kinds of error increase. Application of the matching criteria and tolerance level to an archaeological collection underscores that the analytical requirements of identifying paired bones are steep.     

A possible case of coccidioidomycosis from the Los Muertos site,Tempe, Arizona

Coccidioidomycosis is a fungal disease endemic to southwestern North America and parts of Central and South America. Coccidioidomycosis frequently disseminates to the human skeleton and produces mostly lytic skeletal lesions. However, this disease is infrequently described within archaeological populations. As a result, it is important to report potential cases in order to improve current understanding of the appearance and distribution of lesions resulting from coccidioidomycosis in archaeological specimens. This study describes skeletal lesions in an adult male recovered from the Los Muertos site, Tempe, Arizona (AD 500–1450). These lesions are present on the inferior border of the left scapular spine, the medial portion of the left first metacarpal head, and the medial portion of the right first metatarsal. The lesions are predominantly lytic with sclerotic and, in some cases, healed cortical bone distributed around their margins. Evidence of skeletal healing is recorded within the destructive focus of one lesion. Geographical information on pathogen endemism, overall lesion distribution, and agricultural‐era Hohokom behaviour suggest that coccidioidomycosis is the most likely diagnostic option for these lesions. Mounting evidence for possible infections in the palaeopathological literature, combined with high frequencies of nutritional stress levels in endemic regions, suggests that coccidioidomycosis contributed at least moderately to morbidity in the American Southwest. Copyright © 2006 John Wiley & Sons, Ltd.