A Case of Marked Bilateral Asymmetry in the Upper Limbs of an Upper Palaeolithic Male from Barma Grande (Liguria), Italy

Barma Grande 2, a male skeleton of upper palaeolithic age from Balzi Rossi (Liguria, Italy), shows a marked degree of upper limb bilateral asymmetry. Similar cases of asymmetry in palaeolithic hominid fossils have variously been attributed to high levels of behavioural asymmetry (related to handedness) or a pathologically induced alteration of upper limb skeletal remodelling processes. As in many of these cases, the skeleton from Barma Grande lacks any indications of trauma or pathology in the smaller left limb. Consideration of the morphology of the preserved upper limb elements and a comparative analysis of asymmetry in normal and pathological male palaeolithic fossils and normal recent human samples suggests that the asymmetry in Barma Grande 2 was a secondary effect of trauma or pathology in the left side. The degree and pattern of asymmetry in numerous humeral and ulnar measurements indicates an adult onset of altered loading patterns. Several possible aetiological factors are considered, with the most probable being an entrapment neuropathy, direct trauma to one or more muscles about the shoulder, or possibly glenohumeral joint instability. © 1997 by John Wiley & Sons, Ltd.     

The Sunghir 3 Upper Paleolithic Juvenile: Pathology versus Persistence in the Paleolithic

The Mid Upper Paleolithic Sunghir 3 late juvenile early modern human, from the most elaborate burial in the Pleistocene, had pathologically foreshortened and anteriorly bowed femora and, based on her dental enamel hypoplasias and transverse lines, sustained severe and persistent systemic stress throughout her decade of life. Her modest femoral and tibial asymmetry and her femoral bicondylar angles indicate non‐pathological patterns of posture and locomotion. The levels of rigidity for her weight‐bearing tibiae and the non‐dominant left arm reflect normal weight‐bearing and manipulation. These indicators are combined with an elevated level of right humeral strength, leading to pronounced humeral diaphyseal asymmetry, combined with elevated muscular insertion asymmetry. In combination with marked upper limb muscle markings and normal levels of bone formation, these reflections of her robustness indicate that she was fully mobile and participated actively in the tasks of her social group. There is no indication of the skeletal hypotrophy/atrophy that would be associated with less than full participation in the mobility and subsistence of her social group. As such, Sunghir 3 joins a growing list of developmentally or degeneratively pathological Late Pleistocene humans who nonetheless remained mobile and active. Copyright © 2012 John Wiley & Sons, Ltd.     

Directional bilateral asymmetry in human sacral morphology

Directional bilateral asymmetries in human gross skeletal morphology are largely attributable to differential mechanical loading from handedness during endochondral bone growth. While much has been done in the way of identifying directional asymmetries of the upper limb in relation to handedness, comparatively little research has focused on asymmetry in the lower body. The present paper analyses asymmetry in the human sacrum in a sample of 238 modern individuals. Measurements of right and left sides of the lateral and posterior breadths of the alae and the maximum height of the auricular surface were used. Asymmetry was calculated as: [(left side − right side) ÷ right side] * 100. Directional asymmetry was identified using a one‐sample t‐test against a hypothesized mean of zero. Significant directional asymmetry (P < 0.05) was found in all three dimensions. The pattern of asymmetry is consistent with models describing the influence of right‐handedness on the lower body, which predicts that left side dimensions will be larger. Copyright © 2002 John Wiley & Sons, Ltd.     

Handedness and directional asymmetry in the long bones of the human upper limb

The long bones of the human upper limb usually show lateral asymmetries of length. This pattern can be attributed either to the mechanical consequences of handedness bias or to genetic or hormonal factors acting directly on longitudinal bone growth. Length data was obtained from the long bones of the upper limbs of a large skeletal assemblage from Wharram Percy, Yorkshire (England), predominantly deriving from the 11th-16th centuries A.D. The Wharram Percy adult skeletons had a population distribution of lateral asymmetries of length in the humerus and in the humerus-plus-radius (a proxy arm length index) which closely parallels the pattern of behavioural handedness found in modern populations. This pattern was developing in the skeletons from the infant and juvenile age ranges, but was absent in the neonates (of whom 12 out of 14 had longer left humeri). We argue that this supports the environmental hypothesis that the ontogeny of long bone length asymmetry is consequent to the earlier development of lateral bias in mechanical loading of the upper limbs.     

Limb bones asymmetry and stress in medieval and recent populations of Central Europe

Monitoring the degree of asymmetry in different parts of the human body can contribute to population studies, as it may be connected indirectly with the social structure, living conditions, and also with biomechanical stress affecting the person. Analysis of asymmetry may also assess preferential use of the right or left of the body during specific activities. This study is based on the measurements of bones of the upper and lower limbs of skeletons derived from the remarkable medieval cemeteries of Mikulčice‐Kostelisko (78 male, 132 female) and Prušánky (66 male, 69 female) (9th–12th centuries AD), and a series of skeletons representing a recent population from Bohemia (143 male, 157 female). The objective was to assess directional asymmetry (DA), fluctuating asymmetry (FA) and antisymmetry (AS) of the dimensions of the evaluated bones, and to use these data to compare the characteristics of the medieval and recent populations. DA was recorded in most dimensions. In the upper limb, the humerus exhibited the greatest expression of asymmetry, and, with the exception of the clavicle, DA was always more pronounced on the right side. Conversely, DA was less prevalent in the lower limb bones. It was more pronounced on the transverse, sagittal and circumferential dimensions of the diaphyses and epiphyses than on the length, and in most cases it was on the left side. The FA values were very low, and almost negligible in relation to the size. Nevertheless, FA was markedly more frequent on the lower than on the upper limb. In contrast to the medieval population, the recent population had higher FA and DA values. Thus, we propose that people from this medieval population were subjected to lower developmental stress than the recent sample. Copyright © 2008 John Wiley & Sons, Ltd.     

Assessment of Musculoskeletal Stress Marker Development in the Hand

The analysis of musculoskeletal stress marker (MSM) development is a commonly employed tool in osteological surveys and is used to infer patterns of occupational activity and societal organisation in archaeological populations. Although the majority of research into upper limb MSMs has focused on the bones of the arm, the bones of the hand have been conspicuous by their absence. This is likely to be due to methodological issues surrounding the study of hand bones and a presumed lack of variation in MSM development in this area. To date, there have been no systematic studies investigating the presence and variation in MSM morphology for the muscles of the human hand. To address this issue, a presence/absence scoring system was developed for twelve sites of muscle origin and insertion in the metacarpals and phalanges, which was used to determine bilateral asymmetry in the hands of 31 individuals from the Naval Hospital Cemetery site in Greenwich, London. Analysis found observable variation in MSM development between and within the hands, which could be used to determine patterns of asymmetry within the sample. Comparisons with MSM scores from the humeri of these individuals indicate a differentiation in MSM development and asymmetry between these anatomical regions. Levels of asymmetry in the hands and humeri were generally low, with only the dorsal interossei displaying statistically significant asymmetry. Subsequent upper limb MSM research will benefit from the inclusion of data from the hands. These results do not support the continued use of the humerus as a proxy for MSM expression across the upper limb as a whole and suggest that important information regarding behavioural asymmetry in the hands is being lost because of the continual exclusion of this anatomical unit from MSM research. Copyright © 2011 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.     

Examining Activity Patterns and Biological Confounding Factors: Differences between Fibrocartilaginous and Fibrous Musculoskeletal Stress Markers

The present study examines a sample of 105 hunter–gatherer California Amerinds to determine whether fibrocartilaginous musculoskeletal stress markers (MSMs) are better for activity reconstructions than fibrous MSMs. Femoral and humeral head diameters were measured as proxies to body size. All data were analysed for statistical significance using non‐parametric tests. Fibrous MSMs of the left deltoideus, left and right hip adductors, and left and right tibial soleus correlate positively with body size proxies. For fibrocartilaginous MSMs, the right humeral teres minor insertion negatively correlates with humeral head diameter. Both types of MSMs correlate positively with age. More upper limb fibrocartilaginous MSMs display asymmetry than do upper limb fibrous MSMs. Lower limb sex differences were found at the same MSM sites that correlated with body size. Upper limb sex differences at the right teres major, a fibrous site, and the right triceps brachii, a fibrocartilaginous site, seem to reflect activity patterns. Results suggest that fibrocartilaginous MSMs are more useful in reconstructing activity patterns because they display more asymmetry in upper limbs and are less affected by body size than are fibrous MSMs. Yet, correlations with age and a lack of variability at fibrocartilaginous MSM sites may hinder their utility in activity reconstructions. Copyright © 2012 John Wiley & Sons, Ltd.     

Modern human,early modern human and Neanderthal limb proportions

The limb proportions of 686 subjects (461 men and 225 women) from five ethnic groups (White, Inuit, Gurkha, Bantu, San) have been compared. Stature, limb and skeletal measurements were taken directly from the subjects by one observer. The brachial and crural indices of the Whites were markedly smaller (lower) than those of the other populations. The crural indices of the Inuit were similar to those of the two African populations, but this may be an artefact from relatively small numbers for the Inuit population. There is no sexual dimorphism for the brachial index, but men have larger (higher) crural indices than women, a finding which probably relates to the relatively broad pelvises and consequently long femurs of women. The two African populations have long limb lengths standardized for height compared to the Gurkha and Inuit populations, with the Whites intermediate. This finding is consistent with Bergmann's thermoregulatory rule. The correlations between distal abbreviation and limb abbreviation for both the upper and lower limbs are poor and negative. Relatively long limbs tend to have smaller distal segments than relatively short limbs and for the legs this may constitute a safeguard for the integrity of the medial and cruciate ligaments of the knee. For these five modern populations distal abbreviation cannot be used as a proxy for limb abbreviation and there is no justification for linking distal abbreviation with climatic selection. Skeletal data relating to nine Neanderthal and 25 early modern humans have also been analysed. The analysis confirms marked limb and distal abbreviation for the Neanderthals compared to early and contemporary modern humans, but this conclusion presupposes that the taxonomic classes are correct and that limb proportions were not used originally as a class discriminant. For these archaic populations there is a moderate positive correlation between lower limb abbreviation and distal abbreviation, but the numbers are small and the confidence intervals very wide. In view of the findings for modern populations, and until more relevant fossils are available, it is probably unwise to use the crural index as a proxy for limb abbreviation in archaic populations. Copyright © 1999 John Wiley & Sons, Ltd.     

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.     

A Probable Case of Acute Childhood Leukemia: Skeletal Involvement,Differential Diagnosis,and the Bioarchaeology of Cancer in South America

Cancer involves a complex spectrum of disease conditions. However, cancer has received relatively limited attention in paleopathology and bioarchaeology as it is infrequently encountered in the skeletal record, and its differential diagnosis in dry bone remains challenging. Of all neoplastic disorders, one of the most infrequently described forms in ancient skeletons is leukemia, or the myeloproliferative neoplasms of the reticuloendothelial system affecting bone marrow and blood. This case study describes and interprets a suite of lytic and proliferative lesions in the skeletal remains of an Early/Middle Colonial‐era child (ca. A.D. 1533–1620) excavated at the ruins of Eten, southwestern Lambayeque Valley Complex (north coast of Peru). A secondary burial contained the incomplete postcranial remains of a 5–6 year‐old child whose bones were characterized by abnormal porous loci in the right clavicle, scapulae, long bones of the upper limb, ribs, and thoracic and lumbar vertebrae. Additionally, fine areas of new bone formation were present on the clavicle and ribs. Multiple pathological conditions were evaluated in a differential diagnosis, including taphonomic changes and various bone resorbing and forming disorders. The lesions are most consistent with acute childhood leukemia and represent the first of its kind described in Andean South America. The identification of this condition helps focus research questions involving the bioarchaeology of cancer in the Andes, especially regarding the significance of neoplastic disorders in relation to the broader reconstruction of past human health in Peru. Copyright © 2014 John Wiley & Sons, Ltd.     

Ohalo II man—unusual findings in the anterior rib cage and shoulder girdle of a 19000-year-old specimen

The analysis of the skeletal remains of Ohalo II man, aged 30–40 years at death and dated to 19 000 years BP, shows advanced and highly unusual ossification of the lower costosternal cartilage; the right humerus is morphologically larger and considerably more robust than the left; degenerative changes were noted unilaterally in the right glenohumeral, acromioclavicular and claviculosternal joints. There is a marked asymmetry of the atlas, axis and occipital condyles. The changes in the costochondral area of the lower anterior rib cage are considered to represent an infectious chronic osteomyelitic process. The marked discrepancy in size between the left and right shoulder girdles and humeri, and the evidence of degenerative disease exclusively on one side only may be the result of a traumatic brachial plexus nerve palsy. The asymmetrical atlas and axis are most probably anatomical variants that do not reflect clinical pathology.     

Directional asymmetry in the human clavicle

The human right clavicle tends to be shorter than the left. A range of possible explanations can be advanced to account for this asymmetry. In the present work, clavicular morphology was studied in a medieval skeletal assemblage from Wharram Percy, England, with the aim of evaluating these competing explanations. At Wharram Percy, as anticipated, the right clavicle tended to be shorter. Patterns of asymmetry in curvature, robusticity, vascularization, and in the morphology of ligament and muscle attachment sites were also studied. The patterning in these data at Wharram Percy is consistent with inhibition of longitudinal growth of the clavicle on the dominant side due to lateral bias in mechanical loading, particularly in axial compression. Copyright © 1999 John Wiley & Sons, Ltd.     

Bone remodelling following a lower leg fracture in the 11,000‐year‐old hunter‐gatherer from Vado all' Arancio (Italy)

The Upper Palaeolithic skeleton from Vado all'Arancio (Italy), dated to about 11,330 BP, exhibits a severe ankle fracture healed with residual deformation. Following recovery, this young hunter‐gatherer continued to walk for an extended period of time, albeit in a mechanically altered manner. While right‐left differences in external lower limb bone measurements are relatively low, biomechanical analysis of femur and tibia indicates unusually pronounced asymmetry in all cross‐sectional measures of diaphyseal strength. Asymmetry results primarily from normal side endosteal hypertrophy, and not from hypotrophy of the injured limb, suggesting that this individual resumed active life following recovery. This pattern of asymmetry underscores the role of physical activity in maintaining bone mass. Copyright © 2002 John Wiley & Sons, Ltd.     

Asymmetry and activity-related change in the male humerus

Some previous studies of activity-related change in the human skeleton have been of doubtful validity because specific changes have been related to particular tasks. Claims to establish such relationships have often concentrated on the development of entheses. Such work is marred by the incorrect assumption that muscles work in isolation in the performance of a single activity. In addition, normal skeletal asymmetry is often ignored, as is age and sex. In the present work, paired humeri of males from two medieval British sites, Norwich and Henry VIII's flagship, the Mary Rose, were compared using a series of measurements. Comparison of left and right sides demonstrated that humeral asymmetry decreases with age. Comparison of the sites showed that the Norwich males were more asymmetric than those from the Mary Rose. All asymmetries exhibited a right-sided dominance. The majority of the species is right-handed: the Norwich males followed this trend. The general lack of asymmetry in the Mary Rose males suggests that they were using their arms more equally. When left and right sides were compared directly, a new measurement of the greater tubercle (where three muscles insert) and measurement of the diameter of the head demonstrated that the Mary Rose males had significantly larger dimensions of the left shoulder than the Norwich males. These results extend earlier work, which had suggested a correlation between the use of heavy medieval longbows and os acromiale. Statistical comparison of the sites demonstrated that such work can indicate patterns of activity but not individual occupations.     

Phantoms in Artists: The Lost Limbs of Blaise Cendrars,Arthur Rimbaud,and Paul Wittgenstein

There have been an increasing number of reports of postamputation pain and problems linked to phantom limbs over recent years, particularly in relation to war-related amputations. These problems, which are often poorly understood and considered rather mysterious, are still relevant because they are difficult to treat medically. Functional neuroimaging techniques now enable us to better understand their pathophysiology and to consider new rehabilitation techniques. Phantom limbs have often been a source of inspiration to writers, particularly in the period following the First World War, which was responsible for thousands of amputees. Some artists have suffered from postamputation complications themselves and have expressed them through their artistic works. Blaise Cendrars (1887–1961), one of the greatest authors of the twentieth century, suffered from stump pain and phantom limb phenomena for almost half a century following the amputation of his right arm during the First World War. He suffered from these phenomena until the end of his life and his literary work and personal correspondence are peppered with references to them. Arthur Rimbaud (1854–1891), one of the most famous poets in world literature, developed severe stump pain after his right leg was amputated due to a tumor. He survived for only six months after the procedure but left behind an account of the pain he experienced in correspondence to his family. The famous pianist Paul Wittgenstein (1887–1961), whose right arm was amputated during the First World War, became a famous left-handed concert pianist. The phantom movements of his right hand helped him to develop the dexterity of his left hand. The impact on the artistic life of these three men provides an original illustration of the various postamputation complications, specifically phantom limbs, stump pain, and moving phantom.     

Sexual dimorphism in diaphyseal cross‐sectional shape in the medieval Muslim population of Écija,Spain, and Anglo‐Saxon Great Chesterford,UK

Differences in adult male and female activity patterns may influence levels of sexual dimorphism in physical dimensions, including the cross‐sectional shape of long bone diaphyses. Previous studies of archaeological populations have demonstrated significant differences in diaphyseal shape between males and females. In this study, dimorphism in external diaphyseal shape of upper and lower limb bones (reflected in indices of external diaphyseal diameters), and bilateral asymmetry in these indices, were examined in two medieval populations: Muslim Écija (Spain) and Anglo‐Saxon Great Chesterford (UK). Attempts were made to relate observed patterns to documentary and other osteological evidence for differences in male and female activity patterns. While few significant differences in upper limb bone cross‐sectional shape were observed in either population, significant differences in shape were found in the lower limb diaphyses at Écija at the femoral midshaft and tibial foramen and midshaft levels, and at the tibial midshaft for Great Chesterford. Comparison with published data suggests that these differences are marked for Écija, and perhaps fairly high for Great Chesterford compared with other populations with an agriculture‐based economy. This is consistent with documentary and osteological evidence suggesting marked gender differences in behaviour in medieval Muslim Spain. No significant differences in bilateral asymmetry were found, but the effects of small sample size cannot be ruled out. Copyright © 2008 John Wiley & Sons, Ltd.     

Diagnostic criteria for developmental dislocation of the hip in human skeletal remains

Dislocation is the most severe form of developmental dysplasia of the hip (DDH). It significantly impairs hip function in the young, and may lead to debilitating early‐onset osteoarthritis in adults. To our knowledge no thorough study of a large skeletal population has ever been undertaken to determine the wide range of diagnostic criteria for this condition in pathological specimens. To identify these criteria we have analysed the cases of developmental dislocation from a large series of 6000 individuals (6580 hips) from the medieval cemetery at Spitalfields in London, UK. We describe the changes at the true acetabulum, and have created a four‐stage classification of the false acetabulum. The skeletal response to the altered biomechanics and limb shortening that occurs in developmental dislocation is described in the pelvis, lower limb and spine. This includes asymmetric growth in childhood, and asymmetric degenerative change in adulthood. We conclude with a discussion of the clinical literature on developmental dislocation of the hip that will aid palaeopathologists to estimate the symptoms that an excavated individual may have experienced during their lifetime. Copyright © 2007 John Wiley & Sons, Ltd.     

The prediction of physique from the skeleton

This paper attempts to define the relation between (1) human skeletal measurements and (2) height, weight and physique indices. Admitted to the study were 686 men and women from five ethnic groups (White, Inuit, Gurkha, Bantu and San). In addition to height and weight, subjects had defined cranial and postcranial measurements taken using methods derived from clinical examination techniques. Measurements were checked for reliability. Skinfold callipers were used to allow for the thickness of soft‐tissues overlying bone widths. Adjustment factors were derived from radiological gold standards. Radiological measurements, adjusted for magnification, of the lumbar vertebrae from 42 subjects were also done. A correlation matrix was constructed for the complete study population and all variables to allow a preliminary assessment of useful predictive independent variables. Discriminant scores for classification by gender were calculated. Regression computations, using least square regression, were calculated for six defined reference populations. The regression residuals were examined to confirm fulfilment of assumptions. The results indicated that skull and dental arcade variables yield little information about the size and physique of an individual but have some relevance for group comparisons. Long bone widths are moderately and equally correlated with height and weight. Lower limb bone widths are better correlated with body weight than those of the upper limb. The best predictive variables for body weight are the minimal ‘area’ of the lumbar vertebrae (L1–L4) and regressions involving various bone widths. It is confirmed that height correlates well with the lengths of long bones, but the prediction is improved by the addition of a width from the same bone as a second independent variable. Lower limb long bones are not better predictors of height than upper limb ones. The body mass index is best predicted from the available measurements by a regression with the minimal ‘area’ of L1 and the tibial length as independent variables. A lumbar vertebra, particularly L1, yields important information about height, weight and the body mass index. The patella width is, in part, a marker for mesomorphy. Reconstruction of the ankle to enable the width across the malleoli to be measured would yield useful estimates of weight and height. The findings have been applied to the Paviland femur. A provisional male attribution has been made. The derived height is similar to that of tall modern White men. The physique was probably mesomorphic and ectopenic, the physique of strength rather than mobility, but the confidence intervals are very wide. To enable this sort of assessment to be made more confidently, the study requires replication substituting the precision of magnetic resonance imaging for the relative imprecision of skeletal measurements taken directly from the intact body. Copyright © 1999 John Wiley & Sons, Ltd.