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.     

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.     

‘Rid grasse of bones’: A taphonomic study of the bones from midden deposits at the Neolithic and Bronze age site of Runnymede,Surrey, England

Runnymede has large samples of Neolithic and Late Bronze Age animal bones, with contrasting preservation conditions in both periods. The bone evidence has been used to interpret the formation of the site deposits. There are few articulated bones, and no joins were found in butchered bone, indicating that the area studied did not contain primary refuse. Various aspects of bone alteration have been analysed: (i) the proportion of bones with very good surface preservation was high in the in situ Neolithic excavation units and the basal Bronze Age midden, but bones in the upper units were mostly eroded. These units are reworked flood deposits. The greater degree of fragmentation of the bone in the reworked units has been quantified, using a system of recording the ‘zones’ present on each bone, which allows calculation of the fraction present. It is also demonstrated that the reworked units contain a lower proportion of identified bones and a higher proportion of teeth and iaws than the units with well-preserved bone, (ii) Quantification of canid gnawing shows, unexpectedly, that more was recorded on well-preserved bone. Thus recognition of gnawing depends on bone condition. This also confirms that most of the erosion of the bone surface is a post-depositional phenomenon. The sequence of activities is therefore interpreted as follows: meat was cooked and consumed, and the bones discarded for the dogs. At a later stage, larger bones were picked up and thrown away in the river or midden. Some ethnographic examples of periodic cleaning of farming settlements are cited.     

Osteopathological findings in mummified baboons from ancient Egypt

We present the pathological findings in a historic population of 82 baboon mummies recovered from the animal sanctuary of Tuna-el-Gebel in Egypt, in which we were able to demonstrate a high prevalence of disease. In almost 20 per cent of the baboons, signs were present of chronic malnutrition causing bowing and shortening of the long bones. A further 15 per cent of the animals revealed features of chronic joint or vertebral deformities suggesting poor living conditions in their cages. There were three cases of post-traumatic fractures, three of haematogenous osteomyelitis, one individual showed osteoporosis and one hyperostosis of the scapula of uncertain origin. Additionally, we found one tumour of the pelvic bones with features, which might be attributable to an aggressive osteoblastoma or an osteosarcoma. Our findings clearly demonstrate the high rate of bone abnormalities and the wide spectrum of diseases encountered in Egyptian baboon mummies. These observations contribute significantly to our understanding of the life of ancient Egyptian baboons and particularly to their living conditions.     

The first archaeological case of Madelung's deformity?

An elderly male medieval skeleton excavated from St Gregory's Priory presented with unilateral Madelung's deformity. The right radius and ulna were shortened due to premature fusion of the distal growth plate. The radius displayed lateral and dorsal bowing and the ulna was dislocated posteriorly. Pronation and supination was not possible and the available hand bones presented with disuse atrophy. Degenerative changes had reduced the mobility of the elbow joint and marked cubitus valgus was demonstrated. The unilateral presentation, shortening of the ulna and atrophy of the hand bones and the sex of the skeleton suggest a post-traumatic rather than an idiopathic form of Madelung's deformity. As far as we are aware this is the first archaeological example of this condition.     

Rural Rickets: Vitamin D Deficiency in a Post‐Medieval Farming Community from the Netherlands

Rickets is caused by vitamin D deficiency as a result of limited exposure to sunlight and inadequate diet. In the 19^th century, rickets was endemic in most northern European cities. In post‐Medieval Netherlands, rickets is documented in low frequencies in a few urban samples, but has not been studied in contemporaneous rural populations. Beemster is a rural farming community in the Netherlands that was established in the 17^th century upon drained land, with the Middenbeemster cemetery in use until 1866 AD. Ninety‐five individuals from the ages of 32 weeks in utero to 15 years were examined for rickets in order to understand factors that can cause vitamin D deficiency in rural, non‐industrialized populations. To identify rickets in the Beemster sample, ten features were scored, with bending deformities of the lower limb and one other feature, or at least three non‐bending features, having to be present in order for diagnosis. Nine individuals (9.5%) had evidence of rickets—a high prevalence, especially for a rural community where ample sunlight was available. The two and three year old Beemster infants were most heavily affected with an age‐specific prevalence of 30.4%. Two three‐month‐old infants also had rickets. Some of the affected may have developed rickets secondarily, as a result of a different illness, but cultural practices including prolonged swaddling, occlusive clothing, and keeping the young indoors, are suggested to have contributed to this high rickets prevalence. Dietary variables including poor weaning foods and common episodes of malnutrition may have also contributed to vitamin D deficiency. This study demonstrates the value of careful analysis of pathological conditions in subadults and highlights that rickets was not only a disease of cities, but affected populations that would appear to have been at low risk, because of maladaptive cultural practices. Copyright © 2013 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.     

Healed bone fractures in a jomon skeletal population from the Yoshigo shell mound,Aichi Prefecture,Japan

Healed bone fractures were quantitatively analyzed in an ancient Japanese population. The sample studied consisted of the skeletal remains of 160 adult individuals from the Yoshigo shell mound (ca. BP 3400‐2400), Aichi prefecture, Japan. Healed fractures were diagnosed from the presence of callus formation and/or angular deformity. Fractures were frequently seen in small bones of the hand and foot such as the metacarpals, rather than in large long bones such as the clavicle, humerus, radius, ulna, femur, tibia and fibula. Of a total of 517 intact large long bones, only four fractures (0.8%) were recognized. The prevalence and pattern of bone fractures in the Yoshigo population reflects the relative lack of stress in their life‐style. Copyright © 1999 John Wiley & Sons, Ltd.     

Trauma in the city of Kerma: ancient versus modern injury patterns

Injuries, whether accidental or intentional, have incapacitated humans and their primordial ancestors throughout time, although the injury mechanisms have become increasingly more technologically sophisticated. Interpretation of injury aetiology among past peoples is challenging, and often impossible, however, clinical research from developing countries provides a useful analogy with which to evaluate trauma or health patterns of an ancient society. This paper presents a systematic analysis of cranial and postcranial skeletal trauma among 223 adults who were excavated by George Reisner in 1923 from the city of Kerma (1750–1550 BC), Egypt's ancient nemesis in the struggle for control of the Nile River trade route. A total of 156 injuries (fractures, dislocations and muscle pulls among the skull, long bones, extremities and torso) were observed among 88 individuals, 48 of whom had one injury only. The skull was the most frequently traumatized element (11.2%) followed by the ulna (8.3%); 2.4% (48/2029) long bones were fractured. The modal distribution of the Kerma fractures was compared to the fracture distributions of two samples from India and Nigeria where falls were the most common cause of injury. Some characteristics of the three injury patterns were shared: males suffered the greatest frequency of injury, the economically active people (25 to 50 years of age) presented the most injuries among adults, and a small proportion of the victims had more than one major injury. However, the Kerma distribution of the fractured bones varied dramatically from the clinical injury distributions: the ulna and skull were among the least frequently injured bones in the modern samples, while the radius, humerus and lower leg were the most commonly traumatized elements among the modern people, but rare among the ancients. The configuration of the ulna and skull injuries at Kerma was characteristic of those associated with blunt force trauma in other clinical assessments and the absence of these specific lesions from the modern samples where accident was the primary injury mechanism presents a persuasive argument for interpersonal violence among the ancient Kerma people. Copyright © 2004 John Wiley & Sons, Ltd.     

Variation in human bone bioerosion during the Late Eneolithic/Bronze Age in Moravia (Czech Republic): A novel approach to BSE-SEM image quality and quantity assessment

Human bones from Late Eneolithic graves and Bronze Age settlement pits in Moravia (Czech Republic) were studied to reconstruct their post-mortem histories based on the distribution of their microbial destruction. Backscattered electrons in a scanning electron microscope (BSE-SEM) were used for visual assessment of bioerosion. Visual data from the histological analysis were transformed into quantitative data using the Waikato Environment for Knowledge Analysis (WEKA) toolkit. The results show that the presence of bioerosion is different between the two groups of samples. The bones from settlement pits display extensive bioerosion whereas the bones from graves display no or arrested bioerosion. The absence of bioerosion in graves is most probably linked with tomb burials of Corded Ware Culture. Given the tombs are frequently not preserved archaeologically, the state of bone bioerosion may serve as an indicator of their existence.     

Rickets and child abuse: the case of a two year old girl from the 4th century in Lisieux (Normandy)

The burial of a child of two years of age from the 4^th century site of Lisieux‐Michelet (Calvados, France) was examined for bone hyperplasia and a variety of mechanical deformations recognized in association with skeletal trauma. Results of DNA analysis of bone using the PCR method identified this child as female. Microscopic features of the teeth (interglobular dentine) and a sample taken from the tibia conclusively determined that this child suffered from vitamin D‐resistant rickets and possibly X‐linked hypophosphataemic rickets as its most common form of occurrence. In addition, evidence for child abuse is suspected based on the presence of cranial and tooth fractures and the appearance of successive plaque‐like endocranial (meningeal) appositions. This is the first palaeopathological report of child abuse in antiquity. Copyright © 2002 John Wiley & Sons, Ltd.     

Endocranial lesions in non‐adult skeletons: understanding their aetiology

Reactive new bone on the endocranial surface of the skull in non‐adults has recently received a lot of attention in the palaeopathological literature. These features appear as layers of new bone on the original cortical surface, expanding around meningeal vessels, as isolated plaques, ‘hair‐on‐end’ extensions of the diploë or, as ‘capillary’ impressions extending into the inner lamina of the cranium. These lesions are commonly found on the occipital bone, outlining the cruciate eminence, but have also been recorded on the parietal and frontal bones, and appear to follow the areas of venous drainage. Although recognized as resulting from haemorrhage or inflammation, their precise aetiology is still a matter of controversy. This paper outlines their possible causes and examines their nature and distribution in a group of non‐adults from four archaeological sites in England. It is recommended that, when recording these lesions in the future, additional skeletal pathologies, the age of the child, and nature and distribution of the lesions also be taken into account. Copyright © 2004 John Wiley & Sons, Ltd.     

Dietary Stress and Animal Resource Use at the Postclassic Maya city,Mayapán (Mexico)

ABSTRACT

Environmental changes resulting in drought and reductions in the availability of animal resources during the Late Classic Maya have been linked with the Maya ‘collapse’. Decreases in availability of dietary staples such as artiodactyls, and particularly white-tailed deer, during the Late Classic period would have placed food stress on populations during later periods. To test this hypothesis, here bone breakage patterns are examined at the Postclassic Maya city, Mayapán, to assess whether artiodactyl bones were being intensively processed for bone fats (marrow and grease). Fragmentation morphology, size and surface markings, along with skeletal part representation and distribution of large mammal bones were recorded for bone assemblages from several houselots. Evidence suggests the Maya were likely utilising bone marrow from artiodactyls but not intensively and they were not extracting bone grease. These results indicate that decreased accessibility to artiodactyls during the Postclassic was not causing high levels of dietary stress for the Maya at Mayapán, which is consistent with recent evidence demonstrating dietary consistency during the Postclassic in northern Yucatan.     

Skeletal and Surgical Evidence for Acute Osteomyelitis in Non‐Adult Individuals

Osteomyelitis is a non‐specific infection of the bone and bone marrow. In the past acute osteomyelitis (AO) led to high mortality especially in non‐adults. Nevertheless, its diagnosis in archaeological populations is rare. Documented individuals with known cause of death offer a unique opportunity to study this condition. This article aims to describe the bone lesions in non‐adults diagnosed with AO at the Coimbra University Hospital (CUH) and now belonging to the Coimbra Identified Skeletal Collection (CISC). Moreover, mortality rates and demographic profiles for individuals aged ≤18 years old and diagnosed with AO in the CUH, between 1923 and 1929, were also determined. The 5 (1%) non‐adults in the CISC with AO listed as cause of death were selected for this study, and their bones were analysed macroscopically and radiologically. The skeletal remains of one individual revealed a small area of new bone formation in the shaft of the left femur. Radiography of this bone showed a radio‐opaque area in the diaphysis. The other four individuals show evidence of surgical treatment, responsible for many cases of disability in the past. In the 7‐year period under analysis, 122 juveniles were diagnosed with osteomyelitis and admitted for surgery at the CUH, 43 (35.2%) of which were diagnosed with AO. Sixty‐five per cent of the cases of AO occurred between the ages of 8 and 15 years, with boys twice as frequently affected as girls, and lower limb bones were involved in 91% of AO cases. AO was responsible for 76.9% of the deaths. This study of pre‐antibiotic non‐adults may help to recognize skeletal signs of AO and their surgical treatment in unidentified skeletal remains. Copyright © 2012 John Wiley & Sons, Ltd.     

The Red Fox (Vulpes vulpes) as an Accumulator of Bones in Cave‐like Environments

Identifying the behavioural patterns of bone collecting animals is a crucial aspect of taphonomic studies. Although many studies have established criteria for identifying animal‐collected or animal‐modified bones, very few papers describe the distinguishing features of fox‐made bone assemblages. The bone assemblage collected in an inactive underground stone mine in Potok‐Senderki (Poland) is diagnostic of a red fox (Vulpes vulpes) den. This site provides an ideal opportunity to develop an understanding of the bone collecting behaviour of red foxes in cave‐like environments. This study showed that bones collected by red foxes are concentrated in clusters. The bones represent a broad spectrum of local fox prey species, with most bones showing the marks of gnawing. Each cluster may contain from <10 to >100 bones. Furthermore, the long axes of the bones in clusters frequently show specific orientation. The analysis of bones at this site might make an important contribution towards the establishment of baseline criteria for the identification and evaluation of fox‐accumulated bone assemblages. Copyright © 2012 John Wiley & Sons, Ltd.     

A high status burial from Ripon Cathedral,North Yorkshire,England: differential diagnosis of a chest deformity

Excavations beneath the crossing at Ripon Cathedral in North Yorkshire recently revealed a burial radiocarbon dated to the late 15th century AD. The burial was that of a young adult female; the location of the grave suggests a person of relatively high status. The very well preserved skeleton revealed abnormal changes to the bones of the thoracic cavity including anterior bowing of the sternum, flattening of the spinous processes of thoracic vertebrae three to nine against the processes below each one, and changes to the ribs that suggested anterior displacement of the rib cage. The skeletal changes are described and differential diagnoses presented. Treatment to an underlying chest deformity, ‘pectus carinatum’, is thought to be the underlying cause of the skeletal changes; this study may lend direct insight into the concepts of body image in the Medieval period. Copyright © 2003 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.     

A case of Madelung's deformity in a skeleton from Nuragic Sardinia

The case reported here refers to the skeletal remains of a mature adult male found in a collective grave known as ‘Giant's tomb’ located near Donori (Sardinia) and dating to the end of the Bronze Age. The skeleton showed bilateral shortening of the forearm associated to radial bowing, marked deformations at the radio‐ulnar distal joints and subsequent posterior dislocation of both ulnae. The whole alterations fit well with a diagnosis of Madelung's deformity, a rare form of mesomelic dysplasia. At present, this case is the most ancient evidence of Madelung's deformity. Copyright © 2002 John Wiley & Sons, Ltd.     

Frogs as a part of the Eneolithic diet. Archaeozoological records from the Czech Republic (Kutná Hora-Denemark site, Řivnáč Culture)

Within the site of Kutná Hora-Denemark (Kutná Hora distr., central Bohemia – Eneolithic, ?ivná? Culture, 3000–2800 BC), 893 frog bones or bone fragments were present in five archaeological features. All identified specimens are of the Common Frog (Rana temporaria Linnaeus, 1758). Males predominate, according to humeral morphology, and only adult individuals are present. The most important findings come from feature 36, where an accumulation of 739 frog bones (MNI = 123) were found, of which 10% (NISP) were burned. This and other contextual evidence indicates that they relate to activity of the Eneolithic people in the settlement. The predominance of hind leg bones and other circumstantial evidence suggest that the frogs were part of the human diet. Behavioural studies of this species suggest that the frogs were gathered from small ponds during the months of March or April. Similar findings are rare.