Osteoarthritis in a Black Death cemetery in London

Age-specific prevalence rates were determined in a group of skeletons recovered from a Black Death plague pit in London. The disease showed the expected increase in prevalence with age but these rates were lower than those in the contemporary population and the disease was more frequent in men than in women. In the majority of cases the disease affected one joint only and there were no cases of generalized osteoarthritis. The sites most commonly affected were the facet joints of the spine, the acromioclavicular joint and the hands; there were relatively few cases in which the large joints were affected but the knee was slightly more frequently affected than the hip.     

The distribution of osteoarthritis of the hands in a skeletal population

The distribution of osteoarthritis of the hands was studied in 101 skeletons from archaeological sites in England. The results are similar to those found in epidemiological studies of modern populations. Osteoarthritis of the hands was more common in females than in males, and in females tended to involve a greater number of joints. The distal and proximal interphalangeal joints were commonly affected, the former more frequently than the latter, but otherwise the disease was largely confined to the first ray of the hand, centred on the trapezium. It is concluded that the pattern of osteoarthritis in the hand has probably not changed greatly over several hundred years.     

Morphological changes in the shape of the non‐pathological bony knee joint with age: a morphometric analysis of the distal femur and proximal tibia in three populations of known age at death

This study examines possible morphological variation in the knee joint of Homo sapiens with increasing age in ostensively healthy and non‐pathological distal femora and proximal tibiae. Throughout the lifetime of each individual, the hard tissue of the knee undergoes considerable remodelling as a response to biomechanical stresses, changes in bone microarchitecture and reduction of bone mineral content as a concomitant of ageing. The knee is also subject to greater levels of degenerative joint disease than any other joint. If death occurs whilst such diseases are in the earliest stages, initial bone changes may not be visually obvious in museum specimens. If such specimens are used for comparative analyses, it is hypothesised that changes might render it problematic if all ages are conglomerated into discrete samples. This study therefore investigates the degree to which the distal femur and proximal tibia change shape during ageing and, if changes are present, whether they are expressed similarly in males and females. It also examines whether changes are of greater magnitude than those morphological differences which might exist between populations. In an example population of African‐Americans, results indicate that there is a statistically significant difference in shape between age groups and those differences become progressively greater between the youngest and oldest adults. Results also show that although morphological variation caused by ageing is apparent, those shape differences attributable to sexual dimorphism are more powerful. When two additional populations are analysed jointly with the African‐Americans (Caucasian Americans and the European Spitalfields sample), results indicate that inter‐population shape differences are considerably greater than differences caused by increasing age. Results imply that it is justifiable to combine specimens of all ages into discrete samples for comparative purposes. Copyright © 2007 John Wiley & Sons, Ltd.     

Dolnı́ Věstonice 15: Pathology and Persistence in the Pavlovian

Several lines of archaeological and human palaeontological data from the Moravian earlier Gravettian (or Pavlovian) indicate a high level of mobility among these earlier Upper Palaeolithic human populations. The congenitally abnormal young adult Dolnı́ Věstonice 15 human remains support this pattern. Dolnı́ Věstonice 15 suffered serious developmental abnormalities, most likely as a result of the X-linked dominant form of chondrodysplasia calcificans punctata, that included pronounced infantile and minor later childhood developmental defects of dental enamel (enamel hypoplasia), asymmetrical curvature and angular deformities of the proximal femora, asymmetrical shortening of the femora, a diaphyseal deformity of the distal right humerus, a probable healed left ulnar fracture with associated deformity of the radial diaphysis, elevated length asymmetries of the forearms, and an unusual pattern of anomalies of tooth position and number. These are combined with trivial intervertebral articular degenerations, plus localized pronounced osteoarthritis of the right glenohumeral joint and right second and fifth ray hand proximal interphalangeal joints. Yet, there is little asymmetry of the lower limbs distal of the mid-femora, and both diaphyseal hypertrophy of the humeri, femora and tibiae and relative arm and leg muscle attachment size and moment arms indicate a level of skeletal hypertrophy average to high for an earlier Upper Palaeolithic human. The severe upper limb osteoarthritis may indicate a pattern of pronounced and repetitive carrying or dragging of heavy loads. These data indicate the ability of the population to keep a severely affected individual alive through development, yet they also emphasize the necessity for all individuals to participate actively in the elevated mobility and overall activity levels of these earlier Upper Palaeolithic human populations.     

Osteoarthritis and body mass

Osteoarthritis is the second most common pathology found in anthropological collections. Although a great deal is known about osteoarthritis, it is not yet known whether in skeletal populations there is a correlation between osteoarthritis and body mass. In this study, lower limb and spinal osteoarthritis scores were taken to determine whether body mass and femoral length correlate with osteoarthritis on weight bearing joints. Osteoarthritis was measured using a four-point ordinal scale on a sample of 114 adult prehistoric Californian Amerinds. Body mass was calculated from femoral head breadth; femoral length was measured using standard procedures; and age and sex were determined through standard osteological procedures. Using Spearman correlations, body mass and femoral length did not correlate significantly with any of the osteoarthritis variables. Age correlated significantly with nearly all of the osteoarthritis variables (hip, r = 0.507; knee, r = 0.528; cervical, r = 0.513; thoracic, r = 0.647; lumbar, r = 0.507, P-values < 0.001); and body mass and femoral length correlated with sex (r-values = 0.835 and 0.654, P-values < 0.001). With age and sex controls, body mass negatively correlated with the hip osteoarthritis variable (r = −0.202, P < 0.05), but not with any of the other osteoarthritis variables. Results concur with previous findings in the anthropological literature and highlight complexities of osteoarthritis etiology.     

Skeletal distribution of degenerative changes in vertebral osteophytosis,vertebral osteoarthritis and DISH

In order to comprehend the condition of vertebral osteophytosis, vertebral osteoarthritis and DISH (diffuse idiopathic skeletal hyperostosis) with respect to diagnosis and aetiology, the vertebral and peripheral (appendicular) frequency and distribution pattern of degenerative joint changes of 176 rather affluent citizens were analysed from the late medieval city of Dordrecht in Holland. Patterns of frequencies with respect to age and sex were found to be similar essentially to those of a present-day Dutch suburban village population. Frequencies for vertebral osteophytosis were twice those for vertebral osteoarthritis, and both increased with age in both sexes. The individual pattern of vertebral osteophytosis and vertebral osteoarthritis seems to indicate that each disorder possesses its own progressive identity. From the distribution pattern and frequency of peripheral osteoarthritis it was concluded, with respect to the vulnerability of developing this complication under physically moderate life conditions, that causal factors for vertebral osteophytosis are less important than those for vertebral osteoarthritis. Osteoarthritis presented itself as a systemic disorder, affecting synovial joints in general. Finally it was appreciated that, with increasing age, bony outgrowths from joint degeneration become anatomically masked by para-articular ossifications from DISH.     

Dolní V stonice 15: Pathology and Persistence in the Pavlovian

Several lines of archaeological and human palaeontological data from the Moravian earlier Gravettian (or Pavlovian) indicate a high level of mobility among these earlier Upper Palaeolithic human populations. The congenitally abnormal young adult Dolní V stonice 15 human remains support this pattern. Dolní V stonice 15 suffered serious developmental abnormalities, most likely as a result of the X-linked dominant form of chondrodysplasia calcificans punctata, that included pronounced infantile and minor later childhood developmental defects of dental enamel (enamel hypoplasia), asymmetrical curvature and angular deformities of the proximal femora, asymmetrical shortening of the femora, a diaphyseal deformity of the distal right humerus, a probable healed left ulnar fracture with associated deformity of the radial diaphysis, elevated length asymmetries of the forearms, and an unusual pattern of anomalies of tooth position and number. These are combined with trivial intervertebral articular degenerations, plus localized pronounced osteoarthritis of the right glenohumeral joint and right second and fifth ray hand proximal interphalangeal joints. Yet, there is little asymmetry of the lower limbs distal of the mid-femora, and both diaphyseal hypertrophy of the humeri, femora and tibiae and relative arm and leg muscle attachment size and moment arms indicate a level of skeletal hypertrophy average to high for an earlier Upper Palaeolithic human. The severe upper limb osteoarthritis may indicate a pattern of pronounced and repetitive carrying or dragging of heavy loads. These data indicate the ability of the population to keep a severely affected individual alive through development, yet they also emphasize the necessity for all individuals to participate actively in the elevated mobility and overall activity levels of these earlier Upper Palaeolithic human populations.     

Changes in the distribution of osteoarthritis over historical time

A total of 2635 skeletons recovered from different sites in England was examined for the presence of osteoarthritis (OA); 206 were from pre-medieval sites, 1453 from medieval sites and 976 from post-medieval sites. Where OA was considered to be present in a joint, the site was noted and for each time period the total number of anatomical sites with the condition was determined and the number of major sites with OA (10 in number) was expressed as a proportion of this total. There were no differences in the distribution of osteoarthritis between the pre-medieval and medieval periods but there were between the medieval and post-medieval periods. In the post-medieval period the proportion of osteoarthritis of the knee increased whereas that of the hip decreased; the proportion of osteoarthritis of the hands also increased whereas that of the wrist decreased. Other data presented indicate that patellofemoral disease is about twice as common as tibio-femoral disease in both medieval and post-medieval periods and that lateral compartment disease is almost as common as medial compartment disease.     

Linking Bone Changes in the Distal Femur to Functional Deficits

Knee osteoarthritis (OA) is a condition that leads to functional deficits in the afflicted. Quantifying these deficits in a clinical population and relating them to bone changes in the distal femur is crucial to identifying potential impairment in archaeological populations. This study provides a hybrid knee OA grading system linking MRI observations of clinical populations and direct bone observations on skeletal populations. This system is then related to 28 pain, disability, and activity limitation outcome variables provided by the OA Initiative through frequency distributions, probability profiles, and Spearman's rank correlations. The results suggest that while the five outcome variables with the highest probabilities were common to males and females, bone changes in knee OA impact males and females differently. Copyright © 2012 John Wiley & Sons, Ltd.     

The Relationship between the Two Types of Vertebral Degenerative Joint Disease in a Joseon Dynasty Population,Korea

The purpose of this research was to explore the relationship between degenerative joint disease (DJD) in the apophyseal joints and intervertebral joints in the vertebral column and assess which vertebral DJD is the more reliable indicator of general activity‐related stress. We hypothesized that the more reflecting vertebral DJD for general activity‐related stress would appear to show a higher correlation with Schmorl's nodes (SNs). To test this hypothesis, we examined 125 individuals from Eunpyeong Cemetery (mid‐15th to early 20th centuries) in Seoul, Korea and analyzed the frequencies of two types of vertebral DJD and their relationship with SNs. Cross‐tabulation chi‐square tests were used to evaluate the significance of the differences between frequencies of vertebral pathologies. In conclusion, results revealed that the relationship between the two kinds of vertebral DJD appeared differently depending on vertebral region, joint type and sex. The test results of association between the two types of vertebral DJD were statistically significant at the cervical and lumbar regions of males. SNs appeared independently of the pattern of vertebral DJD in nearly all joints with the exception of a correlation between DJD in the intervertebral joints and SNs of the lumbar region in females. As indicated in some studies, this study reconfirmed that the differences in the two kinds of vertebral DJD result from differences in normal vertebral morphology and anatomical function. This study contributes to the overall discussion on the relationship between vertebral DJD and physical activity by showing that the detailed recording and understanding of the two types of vertebral DJD is required before they can be used convincingly in a study on activity‐related stress. Copyright © 2012 John Wiley & Sons, Ltd.     

Antemortem pathological changes suggestive of reactive and degenerative arthritic disorders

The present case displays severe antemortem skeletal malformations suggestive of antemortem reactive arthritis (ReA), spondyloarthropathies and diffuse idiopathic skeletal hyperostosis (DISH). The ossified anterior longitudinal ligament on the right side of the thoracic vertebral bodies, with the presence of extraspinal enthesophytes, together indicates DISH. Fused lumbar vertebrae with costovertebral and sacroiliac joint fusion, combined with numerous large enthesophytes collectively suggest ankylosing spondylosis and ReA. Finally, some vertebrae showed evidence of age related osteoarthritis. However, the anatomical evidence for these conditions displays some inconsistencies with the known pathogenesis; therefore, a definitive account of this individual's antemortem condition remains uncertain. As no biological or medical information is known about the individual, skeletal morphology, irregular skeletal fusion and the presence of enthesophytes have been collectively used to propose the antemortem disorders that appear to have affected this individual's skeleton. Copyright © 2010 John Wiley & Sons, Ltd.     

Skeletal markers of occupational stress in the Fur Trade: A case study from a Hudson's Bay Company Fur Trade post

The Seafort Burial Site (FcPr100) is a Fur Trade Period cemetery located near the town of Rocky Mountain House, Alberta. The results of recent analysis of skeletons recovered during salvage excavations between 1969 and 1971 suggest that three males in this sample were voyageurs in the employ of the Hudson's Bay Company. Vertebral osteophytosis and osteoarthritis, Schmorl's nodes, muscle origin robusticity and new bone formation at entheses and syndesmoses, and osteoarthritis at the elbow and shoulder joints provide evidence for carrying, lifting, and paddling or rowing. The presence of accessory sacral facets also may be stress-related. In addition, the development of accessory articular facets on the metatarsals and proximal pedal phalanges may indicate activity-induced stress from hyperdorsiflexion of the toes in habitual kneeling, such as when river canoeing.     

Inter-observer variation in coding osteoarthritis in human skeletal remains

Thirty-eight participants at the VIIIth European Meeting of the Paleopathology Association took part in a study of inter-observer variation in scoring osteoarthritis in human skeletal remains. Ten specimens representing different joints were used and five criteria of osteoarthritis were scored. Eleven of the 38 participants ranked themselves as beginners, 13 as experienced and six as very experienced; the data were subsequently examined using the results from these 30, comparing beginners with experts. Agreement as to whether or not changes were present on the specimens and on the degree of change was seldom complete but was greater when scoring eburnation and the presence of new bone on the joint surface than for the three other criteria. There was little difference between beginners and experts. Although all the specimens were chosen to meet our published criteria for osteoarthritis, the experts were unanimous is agreeing the diagnosis in only three cases and the beginners in only one. These results suggest that more work needs to be done to develop operational definitions for the classification of disease in palaeopathology and that great care must be taken when comparing disease frequencies between studies.     

A palaeopathological investigation of the third intercondylar tubercle of Parsons

The third intercondylar tubercle of Parsons (TITP) is a bony protuberance which is sometimes present on the tibial plateau. It corresponds to the insertion of the anterior fibres of the anterior cruciate ligament (ACL). Reasons why TITP is present in some knees and not others are at present unclear. TITP is studied in knee joints from 68 adult individuals from a medieval cemetery. Associations are investigated with age, sex, knee osteoarthritis, clinical and subclinical DISH, and skeletal signs of trauma, with the aim of evaluating existing ideas on the causation of TITP. Only trauma showed an association with the presence of TITP. The results offer support for the aetiology of trauma to the ACL in the formation of TITP. Copyright © 2008 John Wiley & Sons, Ltd.     

The angle of femoral torsion: An impossible measurement?

Torsion of the femur (ante- or retroversion) is a normal feature of the bone. It is related to the angular difference in orientation between the proximal and distal articulations. Torsion has been studied, both in vivo and in dry bone, using a variety of techniques, from a traditional goniometer to radiographs and tomography. Problems with the accurate measurement of the angle of femoral torsion have been encountered by many workers, resulting in a wide range of reported values. A pilot study was undertaken to attempt to demonstrate the difficulties in measuring the angle in dry bone. It was demonstrated that, using standard equipment, measurement of this angle has very poor reproducibility. Is it possible, therefore, to measure the angle of femoral torsion accurately?     

A 3D morphometric analysis of surface geometry in Levallois cores: patterns of stability and variability across regions and their implications

Levallois cores and products were manufactured by hominin populations distributed across wide regions of Africa and Eurasia. Levallois technology remains an important focus for research in Palaeolithic archaeology, yet quantitative morphological comparisons of Levallois core morphology from different regions remain rare. Here, utilizing Levallois cores from Africa, the Near East, Europe, and the Indian subcontinent, patterns of morphological variability in the shape of the Levallois flaking surface and core outline (margin) shape were examined for patterns of variability and stability across regions using 3D geometric morphometrics. The multivariate statistical shape analyses undertaken revealed a clear pattern: that is, the greatest levels of shape variability in Levallois cores is evident in the form of their outline (planform) shape. Conversely, the geometrical relationship between the margin of the Levallois cores and their topological surface morphology was relatively uniform. This pattern of variability was evident in terms of variation both across regions and between cores from the same locality. These results indicate that the outline form of such cores was a less important variable than the geometric/topological properties of the surface morphology and, in particular, the relationship between the margin of the core and those variables. These results have implications for why it has been reported that replicating such cores in modern experiments is a particularly difficult task. The specific interrelationship between the geometric properties of the core and the core margin provide further evidence that Levallois core technology would be unlikely to emerge from the context of opportunistic migrating platform reduction strategies (such as those seen in many Mode 1 industries). If, as is widely suggested, Levallois cores were deliberate products in Pleistocene contexts, these results also hint that relatively sophisticated means of social transmission (i.e. teaching) may have been required to sustain their production over time and space.     

New light on the acromial attachment of the human coraco-acromial ligament

According to a largely forgotten statement in the anatomical literature, the coraco-acromial ligament is frequently attached to the undersurface of the tip of the acromion as well as to its medial margin. Surgeons, now able to examine this region via an arthroscope, support this observation. Raised impingement facets on the tip region of the undersurface of the acromion, sometimes eburnated because of actual contact with the proximal humerus, commonly complicate disorders of the shoulder-joint complex and are often associated with ossification extending into the attachment of the coraco-acromial ligament. Such enthesophytes thus appear to preserve in ossified form the morphology of the attachment; many seem to arise from the subacromial surface as continuations of impingement facets. Two early 19th century scapulas are described in which much of the soft tissue covering the subacromial surfaces was preserved in mummified form. One had a large enthesophyte apparently extending into the coraco-acromial ligament; the other included some of the superior layer of the subacromial bursa. In both, a tissue containing prominent fibrous strands orientated in the plane of the ligament covered the tip region of the subacromial surface. Short immersion in a solution of sodium orthophosphate softened the dried tissue sufficiently to enable its components to be separated. The fibrous strands had a firm attachment near the lateral acromial margin and passed free across the surface like a sling supposedly into the coraco-acromial ligament. The sling-like character was emphasized in one specimen by the attachment of some fibres to the tip of the enthesophyte. It is postulated that the sling-like character would assist the main ligament to buffer pressures exerted by the proximal humerus in normal function. © 1998 John Wiley & Sons, Ltd.     

Osteometric variation in the Inuit second metacarpal: a test of Allen's Rule

Bergmann's and Allen's Rules predict a relationship between climate and morphology as a thermoregulatory adaptation. These ecogeographic principles predict/explain change in the ratio of body surface area to body mass in hot and cold climates. With regard to Allen's Rule we would expect short and relatively broad limb proportions. Such adaptation should be observable in skeletal architecture. This paper provides a test of Allen's Rule using osteometric data for the second metacarpal from the Sadlermiut of Southampton Island, Northwest Territories, Canada. Following adjustment for body size, ANOVA by sample and sex shows the Sadlermiut second metacarpal to be shorter, wider at the base and deeper at the distal metacarpophalangeal joint, in comparison to an historic sample of European settlers. This pattern of difference suggests an Inuit hand with a thermally adapted morphology, viz. a large mass relative to surface area. Copyright © 1999 John Wiley & Sons, Ltd.