Multiple bone tuberculosis in a child from predynastic Upper Egypt (3200 BC)

Tuberculosis, one of the most ancient human diseases, was present in ancient Egypt and has been observed since predynastic times. Excavations in the predynastic to early dynastic necropolis of Adaima, Upper Egypt (3500–2700 BC) led to the discovery of a number of remarkably well‐preserved skeletons of children. The skeletal remains of a 4.5–5‐year‐old child dated from Nagada III A2 (3200–3100 BC) displayed various lesions on the post‐cranial skeleton: spondylitis on the thoracic (T12) and lumbar (L1) vertebrae, partial lytic destruction of the right radio‐ulnar joint, lytic lesions on the scapula and a clavicle, dactylitis on the short bones of hands and feet, enlargement (spina ventosa) and periosteal new bone formation on the long bones. Radiographs show well‐defined radiolucent (cyst‐like) lesions in the metaphysis and the diaphysis of long tubular bones (ulna, radius, femur, tibia, fibula). The lesions recorded during macroscopic and radiological analysis strongly suggest a case of multiple bone tuberculosis. The occurrence of this case of tuberculosis in a child provides a picture of a period where tuberculosis must have been endemic throughout the population living during the origins of urban settlement in Upper Egypt during the predynastic period. Copyright © 2009 John Wiley & Sons, Ltd.     

Two cases of facial involvement in probable treponemal infection from late prehistoric coastal North Carolina

This paper describes two late prehistoric burials from coastal North Carolina with cranial and postcranial lesions characteristic of treponemal infection. Each case exhibits facial lesions consistent with clinical reports of treponemal infection, but which have not previously been documented in these populations. The suite of facial lesions in one case and a mandibular lesion in the other serve to illustrate the variability inherent in treponemal infections. © 1998 John Wiley & Sons, Ltd.     

Skeletal metastatic carcinoma: A case from 15th–20th century Coimbra,Portugal

This paper discusses the differential diagnosis of unusual and distinct pathological changes in the skeletal remains of a 40+‐year‐old female from 15th–20th century Coimbra (Portugal). The most affected area seems to have been the skull, but multiple lesions, lytic and/or blastic, have been found throughout the post‐cranial skeleton, more specifically in the scapulae, clavicles, humerus, sternum, ribs, sacrum, innominates and femurs. The differential diagnosis of the lesions gave rise to several possible pathological conditions, namely, Langerhans cell histiocytosis (granulomatosis or Histiocytosis X), multiple myeloma and metastatic carcinoma. Various macroscopic and radiological aspects lead us to consider metastatic carcinoma as the most probable diagnosis. Despite the argumentative identity of the possible primary lesion, age, sex and the mixed nature of the osseous response are consistent with cancer of the breast but do not exclude other carcinomas, namely lung cancer. With temporal and regional differences emerging in the frequency of malignant tumours, the identification of new cases becomes important, particularly from geographic areas where few cases have been reported. In fact, the present report adds to the only case of metastatic carcinoma detected in non‐identified Portuguese human skeletal remains until now. Copyright © 2009 John Wiley & Sons, Ltd.     

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.     

Survival of a multiple skull trauma: the case of an early neolithic individual from the LBK enclosure at Herxheim (Southwest Germany)

The Early Neolithic enclosure of Herxheim yielded the human remains of more than 450 individuals mainly represented by cranial vaults and numerous fractured cranial and postcranial bones. The skulls were shaped post‐mortem into skull caps by intentional separation of the cranial base and facial bones. One of these calottes revealed four ante‐mortem traumatic lesions and additional cut marks.The defects of this individual were analysed in detail to obtain information on the chronology and consequences of the traumata and manipulations and their probable intention. Four marks could be attributed to at least two violent incidents because of their different stages in the healing process. There is no evidence of cranial surgery, but the individual may have received some medical treatment and social care to survive the injuries without complications. The peri‐mortem cut marks and the post‐mortem intentional shaping of the skull cap, however, can be seen as typical for the treatment of the Herxheim dead and cannot be attributed to violent conflicts. The results support the evidence gained from preliminary examinations of the Herxheim human remains and suggest a more complex view of the final phase of the Linear Pottery Culture (LBK) in southwest Germany. Copyright © 2003 John Wiley & Sons, Ltd.     

A probable case of metastatic carcinoma from the late prehistoric eastern Tennessee River Valley

There are few described cases of metastatic carcinoma from the prehistoric eastern United States and none primarily differentially diagnosed from the southeast. A mature adult female exhibiting several large lytic cranial lesions suggestive of neoplastic disease was identified in a late prehistoric Mississippian Period (AD 1200–1600) context. Burial 371 is from Ledford Island, a Mouse Creek phase (AD 1400–1500) site from the Chickamauga Reservoir of southeastern Tennessee. It is the only case in this reservoir (total adult n = 843). The radiographs of the otherwise asymptomatic postcranium yielded radiolucencies in both proximal femora, both medial clavicles, the sternum, the surviving humeral metaphysis and fragmentary innominate. The locations are all consistent with metastasized carcinoma. The identity of the possible primary lesion is argumentative. Age, sex and the mixed nature of the osseous response are consistent with carcinoma of the breast but not to the exclusion of bronchogenic, thyroid, or kidney cancers. Copyright © 2002 John Wiley & Sons, Ltd.     

Lysis at the anterior vertebral body margin: evidence for brucellar spondylitis?

Recently, palaeopathologists have begun to diagnose brucellosis in skeletal remains from minor lytic lesions located on the anterior margins of one or some few vertebral bodies, taking these lesions to represent brucellar epiphysitis. However, review of the literature indicates that these lesions have been sporadically noted for some time by palaeopathologists and various different interpretations have been placed upon them. In view of this, a study of these vertebral marginal lesions (VML) was undertaken in a large series of archaeological skeletons from England, with the aim of characterising their morphology and frequency and shedding light upon their causes. In the study material, VML were found only in the lumbar spine, where they occurred with a prevalence of approximately 4%. It was argued that VML are consistent with two principal alternative diagnoses: brucellosis and traumatic anterior disc herniation. Differentiating these possibilities for the VML in the study material was difficult, but the balance of the evidence seemed to favour traumatic anterior disc herniation as the more likely cause. It is concluded that VML should not be used to identify the presence of brucellosis in skeletal remains unless there is further evidence, in the form of additional skeletal lesions or biomolecular evidence for residual brucella bacterial DNA, to support such a diagnosis. Copyright © 2007 John Wiley & Sons, Ltd.     

Metastatic Cancer in the Middle Age: The Possible Case of a Female Skeleton from Bormio (Italy)

Secondary signs of cancer are difficult to assess in the archaeological context, as other lesions may mimic metastases on dry bones. Furthermore, the low life expectancy, lower level of environmental cancer risk factors and pollution than the present times can contribute in limiting the frequency of signs of cancer in archaeological populations. This study focuses on a female adult skeleton from the necropolis of Bormio (North Italy), dating back to Middle Ages, which shows multiple lytic lesions on cranium, upper limbs, ribs and pelvis; lesions are oval in shape, with a diameter ranging from 1–2 to 80 mm. The lesions appearance and distribution at macroscopic and radiographic level, together with sex and age indications, suggest the diagnosis of metastatic cancer. Possible diagnostic hypotheses of the possible sites of original cancer were performed as well, based on modern epidemiological data. Copyright © 2017 John Wiley & Sons, Ltd.     

Consequences of conquest? The analysis and interpretation of subadult trauma at Puruchuco-Huaquerones, Peru

This paper examines bioarchaeological evidence of violence and traumatic injury on subadult skeletal remains from two Late Horizon (A.D. 1470-1540) cemeteries within the archaeological zone of Puruchuco-Huaquerones, Peru. Here we present the frequency and types of traumatic lesions on the 242 subadults analyzed. We observed significant increases in the frequency of subadult trauma, particularly among the burials associated with Spanish Conquest. Specifically, we noted a statistically significant increase in the frequency of cranial trauma in a subsample of individuals from one of two cemeteries at the site, 57AS03. These perimortem cranial injuries suggest an intensification of violence and lethality that may have affected the children from this community. We then discuss the biocultural implications of this analysis within the context of Spanish invasion and conquest.     

Spondylolysis in the lower thoracic–upper lumbar spine in a British medieval population

Spondylolysis is generally a condition of the lower lumbar spine, but occasionally it is observed at cranial to L4. It is generally agreed that spondylolysis in the lower lumbar spine represents fatigue failure of the neural arch. However, whether a biomechanical explanation is adequate to explain lesions cranial to L4 is disputed. Morphological aspects of spondylolysis at T12–L3 (five cases) are compared with those of lesions at L4–L6 (24 cases) in a mediaeval English skeletal series with the aim of shedding light upon any differences in aetiology of lesions at the two sites. It was found that spondylolysis at T12–L3 was more often unilateral than in L4–L6. In T12–L3, clefts more often took an angulated, dog‐leg course across the pars interarticularis, whereas most in L4–L6 were fairly straight and had an oblique orientation. In T12–L3, clefts often had facetted opposing surfaces suggestive of a diarthrodial joint, but this was only seen once in L4–L6. It is suggested on morphological grounds that facetted defects are more likely congenital than acquired. The need for consideration of factors in addition to activity regimes when interpreting spondylolysis in earlier populations is emphasised. Copyright © 2007 John Wiley & Sons, Ltd.     

Craniofacial trauma in the Prehispanic Canary Islands

The current project is a study of craniofacial trauma in a large sample (n = 896) of Prehispanic Canary Islanders (PCIs). The possible causes and social implications of the trauma found are considered, with reference to archaeological and historical data. Variables include the island, period and ecology, the sex and age of the individuals, the distribution of lesions across the skull (by side and by individual bone) and ante‐mortem tooth loss. The results show a fairly high trauma rate (16%), a low prevalence of peri‐mortem trauma (3.8% of all lesions), higher prevalence of trauma in males than in females (25% vs. 13% of all individuals), more cranial than facial lesions (8.9% vs. 3.5% of all elements) and more lesions on the left side of the skull (6.7% vs. 4.5% of all elements) which suggests that the lesions were sustained through intentional rather than accidental agency. There was no correspondence between trauma prevalence and ecology. The archaeological and historical data support the assertion that the lesions may be the result of skirmishing between groups, using weapons such as slingshots, stones and staves. The presence of edged‐weapon lesions on some individuals suggests that these may have been the victims of contact‐period European groups. Copyright © 2007 John Wiley & Sons, Ltd.     

Palaeoepidemiological Patterns of Trauma in a Medieval Nubian Skeletal Population

Evidence of trauma was investigated in a well-preserved skeletal sample from the Medieval Sudanese Nubian site of Kulubnarti. The skeletal materials derive from two temporally over-lapping Christian cemeteries, dating from the sixth to circa the sixteenth century. The available sample consisted of the skeletons of 146 adults which were investigated for fractures of the long bones, crania and the hands and feet, as well as for dislocations and muscle pulls. Results showed a high incidence of long bone fractures, seen especially in the forearm, and involving 33.5 per cent of individuals. Many of these lesions indicated quite severe injury, and an unusually high number of affected individuals (27 per cent) showed multiple long bone involvement. Conversely, only one possible cranial fracture was apparent. Fractures were also found in 13 hand and seven foot elements. In addition, one hip dislocation and evidence of pulled tendons in 11 individuals were also observed. Compared to other similarly controlled samples, the Kulubnarti population stands out for its high prevalence of healed fractures, the high proportion of multiple involvement and the severity of numerous lesions. The forbiddingly harsh and uneven terrain of this region of Nubia was most likely a major influence on the unusually high prevalence and pattern of traumatic lesions in this group. © 1997 by John Wiley & Sons, Ltd. Int. J. Osteoarchaeol., 7 : 103–114 (1997) No. of Figures: 5. No. of Tables: 5. No. of References: 25.     

Weapon‐related Cranial Lesions from Medieval and Renaissance Turin,Italy

Archaeological excavations carried out in the square around the Cathedral of S. Giovanni in Turin brought to light burials referable to the medieval and Renaissance periods. The anthropological examination of the skeletal remains allowed to identify two skeletons from the medieval period (10th–11th centuries) and four skeletons from the Renaissance age (15th century) showing weapon‐related cranial injuries. These peri mortem lesions are indicators of interpersonal aggression and in particular of armed conflicts. The two individuals from the early medieval period presented three traumas consisting in sharp force lesions caused by bladed weapons. As regards the Renaissance sample, the majority of the nine peri mortem injuries were sharp force wounds, followed by a blunt force trauma. These distribution patterns might reflect different fighting techniques, whereas the side distribution and location of the skull trauma provide further indications on the fighting modalities. Identification of the weapons that caused these traumas is suggested. The lack of post‐cranial wounds at Piazza S. Giovanni might be explained by the greater attention paid to the head, which was the main target of attack, or by adequate protection of the body through medieval and Renaissance armours. Otherwise, the wounds in the body would have been found only in the soft tissues, with no involvement of the bones. Despite the presence of weapon injuries, the results obtained from the study of the Renaissance sample are different from the findings of other contemporary battlefields. It is highly likely that the individuals of the Renaissance age were not young soldiers employed in war episodes and brought back for burial in Turin after battles that had taken place elsewhere. Instead, they were probably individuals who had died in riots or in other violent city episodes, as the historical records for the Renaissance age seem to confirm. Copyright © 2013 John Wiley & Sons, Ltd.     

An Unusual Erosive Arthropathy from Medieval England

In palaeopathology, diagnosis of skeletal disease is classically made with reference to changes wrought by known diseases in modern or recent cases. This report presents a skeleton from medieval England which shows a form of erosive arthropathy. A more precise diagnosis is problematic because the alterations appear inconsistent with any of the principle forms of erosive arthropathy in current clinical classification. The distribution of lesions in the axial and appendicular skeleton resembles that in seronegative spondyloarthropathies. The nature of the lesions however, which are almost entirely lytic and concentrated principally at synovial articulations rather than entheses, is inconsistent with seronegative spondyloarthropathies and is more consistent with pathophysiology of rheumatoid arthritis. These observations raise the possibility that the manifestations of erosive arthropathies may have altered over time and/or that our clinical understanding of the skeletal distribution of lesions in these diseases may be incomplete. These scenarios would have profound implications for our ability to identify the various forms of erosive arthritis in archaeological populations, but further work investigating erosive arthritis in patients, together with systematic studies of skeletal cases, would be required before firm conclusions can be made. Copyright © 2016 John Wiley & Sons, Ltd.     

Childhood Cranial Trauma from a Late Roman and Merovingian Context from Michelet,Lisieux, France

The Michelet necropolis in Lisieux, France, dating to the late Roman and Merovingian period, comprises of a large number of well‐preserved subadult remains offering a unique opportunity to better understand childhood trauma in the past. The focus of this study was to determine the amount, type and mechanisms of trauma evidenced in subadults from the 4th–8th century AD, and explore potential circumstances surrounding the trauma. The remains of 109 subadults from the Michelet necropolis were examined for the presence of cranial and post‐cranial trauma. Three individuals exhibited perimortem trauma, one individual had an antemortem cranial injury, and no cases of post‐cranial trauma were identified. Cranial trauma affected 4.1% of children with observable cranial remains (N  = 4/97). The children affected were young (2–7 years old), making it unlikely that they would have participated in militaristic activities. Based on the location, morphology and mechanism of injury identified, it is likely that the perimortem injuries sustained by three children were not accidental. The presence of a number of cranial injuries from this site may be related to increased stress in the community related to the decline of the Roman Empire in Gaul, possible raiding barbarian groups during the 4th–5th centuries, or stresses related to the Gallic aristocracy solidifying political powers in northern Gaul during the 5th–7th centuries AD. The consideration and inclusion of childhood trauma in bioarchaeological analyses allows for a more detailed and in‐depth understanding of violence and childhood in the past. Copyright © 2017 John Wiley & Sons, Ltd.     

A Case of Osteosarcoma in a Late Medieval–Early Modern Skull from Kyjov (Czech Republic)

After the reconstruction of the original parish church of the Moravian town of Kyjov in the latter part of the seventeenth century, human skeletal remains from the disturbed graves of the surrounding cemetery were gathered in a vault which was partially excavated in 1994. Among disarticulated bones of at least 106 individuals, a fragmented skull of a young male was found, with a massive outgrowth of bone on the right parietal, originally continuing fluently on the non-preserved frontal scale, on edges lifting the outer lamina. The inner lamina was covered less intensively by the bony growth. Radiography and CT scans showed a non-homogeneous structure, the inside being irregular and the outside granulated or radially striated. A metastatic lytic focus was detected in the same bone. Histology and SEM examination showed an uneven mineralization of the bone tissue, consisting of rough, thickened and irregularly spaced trabeculae, with cellular remains or mineralized matrix on the surface. The differential diagnosis took meningioma into consideration but the most probable diagnosis was osteogenic sarcoma, which is still infrequent in the palaeopathological record from the Old World and its localization in the cranial vault is very rare. © 1997 by John Wiley & Sons, Ltd.     

Re‐examining the relationship between cranial deformation and extra‐sutural bone formation

The relationship between cranial deformation and the occurrence of extra‐sutural bones remains poorly understood. Scholars are divided about whether or not cranial deformation causes an increased occurrence of these bones, and even those who agree that deformation does have an influence often disagree about which locations on the crania are most impacted. Part of this issue clearly stems from the difficulties in finding appropriate samples from which to test the hypothesis that deformation leads to an increased expression of extra‐sutural bones. The present study examines the effects of fronto‐occipital and occipital‐only deformation on the occurrence of extra‐sutural bones through an analysis of 59 deformed and undeformed crania from the Philippines. Relative to the undeformed crania, both deformed samples showed an elevated number of extra‐sutural bones. Using two different statistical tests, we identified a significantly higher occurrence of extra‐sutural bones at two distinct cranial localities for both the fronto‐occipitally deformed crania (coronal suture and asterion) and for those showing only occipital flattening when compared to the undeformed crania (lambdoidal and asterion). However, as our data reveal, individuals with highly elevated occurrences of extra‐sutural bones are not necessarily deformed. As such, we argue that deformation practices may have a positive impact on the formation of extra‐sutural bones; however, future studies using larger samples of deformed and undeformed crania—ideally from the same site—will be necessary to distinguish between the influence of cranial deformation on extra‐sutural bone formation relative to other population factors which may play a role in shaping variation in this feature. Copyright © 2010 John Wiley & Sons, Ltd.     

Multiple Cases with Probable Treponemal Infection from 16th to 19th Centuries Romania

In this paper, we describe pathological lesions identified in seven skeletons discovered in the Saint Sava necropolis in Bucharest, Romania, dating to the Late Medieval/Early Modern period. The pathological changes observed in the skeletons were analysed using macroscopic examination. Additionally, computed tomography scanning was performed on two individuals displaying advanced lesions on the cranial surface. For the differential diagnosis, we took into consideration treponemal infection, tuberculosis, osteomyelitis, leprosy, fluorosis, melorheostosis, hypertrophic pulmonary osteoarthropathy, Paget's disease and mycotic infection, along with the possibility of multiple afflictions occurring simultaneously. The morphology and distribution of the lesions are suggestive of treponematosis, which, to our knowledge, makes this the first case of this disease on the Romanian territory in archaeological populations. Copyright © 2015 John Wiley & Sons, Ltd.     

Thorn Lesions in a Modern Osteological Collection of Guanaco (Lama guanicoe): A New Paleoenviromental Proxy and Its Implications for Archaeofaunal Assemblages

This paper provides a detailed analysis of thorn lesions found in lower limb elements of a modern osteological collection of guanaco (Lama guanicoe). Four types of lesions were recorded: (1) thorns visible on the bone surface, (2) bony reaction with relief, (3) small negative scars and (4) medium negative scars. The methods used to recognise, record and quantify these lesions are presented. As a result, 35 of the 36 individuals analyzed contained one or more types of lesions. The highest concentrations of lesions were recorded on the anterior view of the metacarpal shafts. All the age ranges were affected by lesions; however, individuals between the ages of 1 and 3 years were the most affected, whereas those between the ages of 0 and 1 year contained the least amount of lesions. To provide examples of how thorn lesions can be identified and used as a paleoenvironmental proxy in the fossil record, we analyzed two archaeological sites from different phytogeographic provinces: Bajo de la Quinta (Monte phytogeographic province) and Calera (Pampa phytogeographic province). Results found that 25% of the elements from the Bajo de la Quinta site contained lesions, whereas none of the elements from the Calera site showed evidence of lesions. When detectable in the fossil record, thorn lesions can provide an indirect approximation of the paleoenvironment. Copyright © 2011 John Wiley & Sons, Ltd.