An investigation of historical and archaeological evidence for age‐related bone loss and osteoporosis

A growing awareness of the problems caused by osteoporosis‐related fractures has led to increased investigation of the condition in past populations. The present study seeks to examine the ways in which osteoporosis‐related fractures may be explored through different approaches; modern clinical information, historical records of fractures and analysis of archaeological bone may provide fuller information on the condition. The three types of fractures upon which this study focuses are fractures of the femoral neck, Colles' fractures and vertebral compression fractures. The results of the investigation clearly demonstrate the way in which the various sources produce a slightly different picture of the condition. The archaeological significance of the different types of fractures was found to be the reverse of that which would be suspected in the light of information derived from historical sources and the clinical literature. To date vertebral crush fractures have been the most commonly found osteoporosis‐related fracture in archaeological material, but their significance to people in the past is likely to have been minimal. In contrast hip fractures have rarely been reported from archaeological bone material, but historical information makes it clear they were well known, and knowledge derived from clinical sources emphasizes the serious consequences of such a fracture for the affected individuals. The results indicate the value of undertaking a multi‐disciplinary approach where possible. Copyright © 2002 John Wiley & Sons, Ltd.     

Metastatic carcinoma in a 14th–19th century skeleton from Constância (Portugal)

During 2002, the extensive archaeological excavations of the ancient Constância necropolis (Centre of Portugal), dated from 14th–19th centuries, resulted in the exhumation of 151 individuals. Among the several paleopathological cases, a middle‐aged female skeleton with osteolytic lesions in her skull, axial skeleton, upper limbs and femurs was observed. These pathological findings are characterised by an asymmetric pattern with osteolytic focus of distinct size and irregular shape. Some skeletal elements display both osteolytic and osteoblastic lesions. The latter exhibit deposition of fine layers of woven bone. Lesions were observed macroscopically and radiology was used as a complementary method of scrutiny, especially in cases of unclear observation. The case was diagnosed as that of a probable metastatic carcinoma due to the multifocal distribution of the lesions in areas of intense haematopoietic activity, their morphology and some osteoblastic responses, as well as the presence of pathological fractures in the ribs. The skeleton's sex and age at death are in agreement with the proposed diagnostic, constituting the first case of malignant carcinoma detected in non‐identified Portuguese human skeletal remains. Copyright © 2009 John Wiley & Sons, Ltd.     

A Late Neolithic Case of Pott's Disease from Hungary

The aim of this study was to present classic bone lesions caused by tuberculosis, as seen in a Late Neolithic–Early Copper Age osteoarchaeological sample deriving from the site of Alsónyék‐Bátaszék (the western part of Hungary from the 5th millennium bc ). In one particular case of an adult male skeleton, vertebral bodies' destruction, collapse, ankylosis and marked angulation in the lower thoracic and the upper lumbal region of the vertebral column were observed. The collapse resulted in a severe gibbus formation. The paleopathological analysis was carried out using morphological observation supported by radiological analyses. The results from this study increase our knowledge of the early occurrence of skeletal tuberculosis in past populations. Copyright © 2012 John Wiley & Sons, Ltd.     

The New ‘Coimbra Method’: A Biologically Appropriate Method for Recording Specific Features of Fibrocartilaginous Entheseal Changes

This paper presents a revised version of the Coimbra method for recording fibrocartilaginous entheses. The method itself is the only biologically appropriate recording method for fibrocartilaginous entheses that scores features separately, thereby ensuring that the aetiology of individual features can be studied. The method divides the enthesis into two zones, scoring the relevant features in each zone. These features represent either bone formation or bone destruction and include erosive lesions, fine and macro‐porosity, and cavitations. The revised method includes a new feature, textural change, which is scored as absent or present when it involves 50% or more of the surface. All other features are now scored as zero (absent), one or two with the higher score representing greater expression of the feature. This change in scoring has led to the reduction of inter‐observer error with approximately 80% agreement for overall feature scores for both the common extensor origin and subscapularis insertion. The simplification of the scores and the reduction in inter‐observer error mean that the method is now recommended for widespread use. Copyright © 2015 John Wiley & Sons, Ltd.     

Embryotomy in the 19th Century of Central Italy

An enormous earthquake in L'Aquila in 2009 brought to light human bodies buried in the underground rooms of the medieval St. John the Evangelist church (Casentino, Central Italy). Among the remains, we discovered a human fetus, whose post‐cranial bones were wrapped in bandages and cranial bones were reallocated inside a sort of hood. Anthropometrical investigation revealed an age at death of 29 ± 2 weeks of pregnancy for the little mummy. Radiograph analysis of the fetus showed that the skull was dissected and disconnected from the vertebral column, and the post‐cranial bones were completely disarticulated from the axial skeleton. The body was reassembled in a way of anatomic connection at a later stage. This mummified fetus dated to ad 1840 showed paleopathological evidence of a possible embryotomy and could be a rare and unquestionable case of embryotomy in archaeological context. Copyright © 2014 John Wiley & Sons, Ltd.     

Scapular stress fracture: a palaeopathological case consistent with crutch use

This report describes a defect on the right scapula of a 50 to 60 year old male slave who had been buried extra‐muros in the Le Colombier cemetery of Vaison‐la‐Romaine (5^th to 6^th century AD) in Vaucluse, France. This injury can only be described as a stress fracture, most likely associated with heavy and persistent use of the humerus in abduction. Other bony defects on the skeleton included early signs of ossification of the glenohumeral joint, slight vertebral discopathy, and osteoarthrosis on the right hip. A relationship between scapular stress fractures and walking devices has been described in the current medical literature, and taking this in consideration, possible aetiologies for this scapular defect include either consistent use of a crutch or routine physical labour. Little information is available on either stress fractures or assisted walking devices in antiquity; therefore this information is a valuable contribution to palaeopathology. Copyright © 2008 John Wiley & Sons, Ltd.     

Schmorl's nodes: clinical significance and implications for the bioarchaeological record

Back pain is one of the major contributors to disability and loss of productivity in modern populations. However, osteological correlates of back pain are often absent or, as yet, unidentified. As bioarchaeologists depend on osteological evidence to interpret quality of life in the past, back pain, with its profound effects on modern populations, is largely overlooked in archaeological samples. This study addresses this shortcoming in bioarchaeological analysis by exploring the relationship between a defined vertebral osteological lesion, the Schmorl's node, and its effect on quality of life in a clinical population. Using patient insight, healthcare practitioner diagnoses and MR imaging analyses, this study investigates: (1) Schmorl's nodes and sociodemographic factors; (2) the number, location and quantitative aspects (e.g. length, depth, area) of Schmorl's nodes, and how these influence the reporting of pain; (3) the dynamic effects of Schmorl's nodes, in combination with other variables, in the reporting of pain; and (4) the perception and impact of pain that patients attribute to Schmorl's nodes with regard to quality‐of‐life issues. The results of this study indicate that Schmorl's nodes located in the central portion of the vertebral body are significantly associated with patient reporting of pain, and that the presence of osteophytes, in the affected vertebral region, may increase the likelihood that an individual will report pain. This finding provides bioarchaeologists with an osteological correlate to begin interpreting the presence and impact of pain in archaeological populations, with implications for scoring Schmorl's nodes. Copyright © 2007 John Wiley & Sons, Ltd.     

A 14th–17th century osteoporotic hip fracture from the Santa Clara‐a‐Velha Convent in Coimbra (Portugal)

Osteoporosis is an evocative term for a metabolic disorder characterized by loss of bone mass and organization, which predisposes to fracture. The clinical consequences of osteoporosis lie in the problems associated with it, specifically hip, Colles and vertebral fractures. We present here an extracapsular fracture of the proximal femur in an aged female skeleton from the Santa Clara‐a‐Velha Monastery (14th–17th centuries) in Coimbra, Portugal. This fracture is probably secondary to an osteoporotic disorder. Bone remodeling at the fracture site confirms that this woman survived for a long period after sustaining a fracture of the proximal femur, suggestive of a solid community assistance and support. Copyright © 2009 John Wiley & Sons, Ltd.     

Geometry‐coupled reactive fluid transport at the fracture scale: application to CO2 geologic storage

Water acidification follows CO₂ injection and leads to reactive fluid transport through pores and rock fractures, with potential implications to reservoirs and wells in CO₂ geologic storage and enhanced oil recovery. Kinetic rate laws for dissolution reactions in calcite and anorthite are combined with the Navier‐Stokes law and advection–diffusion transport to perform geometry‐coupled numerical simulations in order to study the evolution of chemical reactions, species concentration, and fracture morphology. Results are summarized as a function of two dimensionless parameters: the Damköhler number Da which is the ratio between advection and reaction times, and the transverse Peclet number Pe defined as the ratio between the time for diffusion across the fracture and the time for advection along the fracture. Reactant species are readily consumed near the inlet in a carbonate reservoir when the flow velocity is low (low transverse Peclet number and Da > 10^?1). At high flow velocities, diffusion fails to homogenize the concentration field across the fracture (high transverse Peclet number Pe > 10^?1). When the reaction rate is low as in anorthite reservoirs (Da < 10^?1), reactant species are more readily transported toward the outlet. At a given Peclet number, a lower Damköhler number causes the flow channel to experience a more uniform aperture enlargement along the length of the fracture. When the length‐to‐aperture ratio is sufficiently large, say l/d > 30, the system response resembles the solution for 1D reactive fluid transport. A decreased length‐to‐aperture ratio slows the diffusive transport of reactant species to the mineral fracture surface, and analyses of fracture networks must take into consideration both the length and slenderness of individual fractures in addition to Pe and Da numbers.     

AN EPR AND ISOTOPIC STUDY OF THE MARBLES OF THE TRAJAN's ARCH AT ANCONA: AN EXAMPLE OF ALLEGED HYMETTIAN PROVENANCE*

The provenance of 20 marble samples drawn from the Trajan's arch at Ancona, which is supposed to be made of Greek, Hymettian marble, has been established on the basis of the independent use of EPR and isotopic data. The results of the two methods are in good agreement and unequivocally indicate a Proconnesian provenance. Sixteen samples are assigned to this site, whereas two are classified as untypical Proconnesian samples and the remaining two are assigned an unlikely Parian provenance. No indication exists for a possible Hymettian origin of the marbles. A multi‐method approach, which employs all of the experimental variables simultaneously, demonstrates that the 18 samples identified as Proconnesian belong to several different quarrying areas within the site. This result is taken as an indication that the Proconnesian quarries were run following a highly organized, semi‐industrial production model. The origin of the Hymettian/Proconnesian misunderstanding and the possible misclassification of other Roman monuments in Italy are briefly commented on.     

Treponemal Disease,Tuberculosis and Subsistence‐settlement Pattern in the Late Woodland Period West‐central Illinois

In later pre‐Columbian prehistory (post AD 1000), the adaptation and intensification of maize agriculture and its correlate of aggregate village settlement (i.e. Mississippianization) is temporally and geographically variable. In the Midwest, consequential to the florescence of the major ceremonial centre of Cahokia (AD 1050–1300), the Mississippi River Valley alluvial plain in Illinois, known as the American Bottom, became a core area of this subsistence‐settlement change. Much archaeological research has traced aspects of this transition in the Lower and Middle Illinois River Valley, but little is known outside of these areas. A skeletal sample from the remote hinterland area of the Upper Mississippi River in west‐central Illinois was examined for arguable paleopathological correlates of sedentism (treponemal disease) and Mississippianization (tuberculosis). The Schroeder Mounds (AD 900–1100) adult skeletal sample (N = 53) exhibited a high frequency of treponemal disease (13.2–15.1%). This result is consistent with paleopathological literature linking a 9+ % pre‐Columbian North American prevalence with sedentism, challenging archaeologically based inferences that the hinterland was occupied by mobile forager‐horticulturalists. A hallmark of Mississippianization is the presence of diagnostic cases of tuberculosis. No cases were observed in the Schroeder sample, suggesting a pre‐Mississippian subsistence‐settlement pattern. Copyright © 2013 John Wiley & Sons, Ltd.     

Diagenesis of the Amposta offshore oil reservoir (Amposta Marino C2 well,Lower Cretaceous,Valencia Trough,Spain)

Samples from the Amposta Marino C2 well (Amposta oil field) have been investigated in order to understand the origin of fractures and porosity and to reconstruct the fluid flow history of the basin prior, during and after oil migration. Three main types of fracture systems and four types of calcite cements have been identified. Fracture types A and B are totally filled by calcite cement 1 (CC1) and 2 (CC2), respectively; fracture type A corresponds to pre‐Alpine structures, while type B is attributed to fractures developed during the Alpine compression (late Eocene‐early Oligocene). The oxygen, carbon and strontium isotope compositions of CC2 are close to those of the host‐rock, suggesting a high degree of fluid‐rock interaction, and therefore a relatively closed palaeohydrogeological system. Fracture type C, developed during the Neogene extension and enlarged by subaerial exposure, tend to be filled with reddish (CS3r) and greenish (CS3g) microspar calcite sediment and blocky calcite cement type 4 (CC4), and postdated by kaolinite, pyrite, barite and oil. The CS3 generation records lower oxygen and carbon isotopic compositions and higher ⁸⁷Sr/⁸⁶Sr ratios than the host‐limestones. These CS3 karstic infillings recrystallized early within evolved‐meteoric waters having very little interaction with the host‐rock. Blocky calcite cement type 4 (CC4 generation) has the lowest oxygen isotope ratio and the most radiogenic ⁸⁷Sr/⁸⁶Sr values, indicating low fluid‐rock interaction. The increasingly open palaeohydrogeological system was dominated by migration of hot brines with elevated oxygen isotope ratios into the buried karstic system. The main oil emplacement in the Amposta reservoir occurred after the CC4 event, closely related to the Neogene extensional fractures. Corrosion of CC4 (blocky calcite cement type 4) occurred prior to (or during) petroleum charge, possibly related to kaolinite precipitation from relatively acidic fluids. Barite and pyrite precipitation occurred after this corrosion. The sulphur source associated with the late precipitation of pyrite was likely related to isotopically light sulphur expelled, e.g. as sulphide, from the petroleum source rock (Ascla Fm). Geofluids (2010) 10 , 314–333     

A regional examination of surgery and fracture treatment in Iron Age and Roman Britain

The study macroscopically examined 270 sexed adults and 190 subadult individuals for evidence of ante mortem fractures and surgical practice in Dorset, during the Iron Age (5th century BC to 1st century AD) and Romano‐British period (1st century to the end of the 4th century AD), in order to understand medical treatment in both periods and determine the extent to which these practices changed post conquest (43 AD). As treatment during these periods is not well understood, a conservative approach to fracture analysis was employed, which attempted to minimise the influence of fracture type and location on results by excluding bones in which fracture deformities may only be corrected by surgery. The study also excluded fractures resulting from bone mineralisation diseases or neoplasms. Skeletal evidence for surgical treatment was identified using funerary, taphonomic and osteological criterion to determine when the surgery took place, and to establish that changes were not caused by post mortem activity. The analysis of fracture treatment demonstrated that in both periods, adult fractures were well set with few secondary changes; a result also influenced by the stable nature of the fracture types. No evidence for sex‐differences in treatment was observed. Evidence for surgery was identified in two Romano‐British individuals: an unsuccessful limb amputation, and an embryotomy procedure that was most likely carried out in an attempt to save the mother. This regional assessment of medical treatment has shown that in both periods, highly skilled practitioners were able to successfully treat a range of fractures and by doing so, minimised the patient's risk of impairment. The study also supplements the very limited archaeological evidence for medical practice and surgery in Iron Age and Roman Britain, and suggests that post conquest, surgical knowledge rapidly increased in association with wider socio‐cultural developments in education, pharmacology and sanitation. Copyright © 2009 John Wiley & Sons, Ltd.     

Schmorl's nodes in a post‐medieval skeletal sample from Klostermarienberg,Austria

The prevalence and distribution pattern of Schmorl's nodes (SNs) were studied in a post‐medieval skeletal sample (n = 473) from the 16^th–18^th century cemetery of Klostermarienberg, Austria. The reasons for the prevalence and distribution pattern of SNs in this sample are discussed with regard to their aetiology. SNs were correlated with age and sex as well as with degenerative spinal joint disease such as vertebral osteophytosis (VO) and apophyseal osteoarthritis (OA). SNs were most commonly found in the lower thoracic region, in agreement with other studies. Males were more affected than females by SNs, especially in the lower thoracic region. SNs show a completely different distribution pattern to VO and OA. Additionally, there was no relationship found between SNs and ageing. Observed differences in the prevalence of SNs in the vertebral column and between the sexes suggest that mechanical factors may be responsible. Copyright © 2008 John Wiley & Sons, Ltd.     

Cargoes of Iron Semi‐Products Recovered from Shipwrecks off the Carmel Coast,Israel

Underwater surveys along the Israeli Carmel coast have revealed six cargoes of iron semi‐products associated with shipwrecks. They are described and dated according to the associated artefacts. Metallographic and chemical analyses on samples from the biggest cargo have determined the stages of the chaîne opératoire, identified the properties of the iron and characterized the iron trade along the Israeli coast. The new discoveries contribute to our understanding of the circulation of iron in the South Levant, which was characterized by an almost complete absence of local iron production. During the Byzantine and Crusader periods, this absence was compensated by long‐distance sea trade, depending on political circumstances and restrictions. Three main types of iron semi‐products were identified: (a) partly consolidated blooms, (b) short pointed bars and (c) elongated pointed bars. The cargoes discovered represent a time period of nearly a millennium. Altogether, 148 iron semi‐products were studied. Of these, 166 were from cargo a, which was dated by coins to around 1130–1200 ce . Those coins could have been imported from Europe for Crusader military and civil uses in the Levant. The iron from cargoes b, d and f, dated perhaps to the Byzantine period, could have been imported from Anatolia or Venice for military and civil purposes.     

Precipitation of fracture fillings and cements in the Buntsandstein (NW Germany)

The relationship between fracturing and fracture filling in opening‐mode fractures in the Triassic Buntsandstein in the Lower Saxony Basin (LSB; NW Germany) has been studied by an integration of petrographic and structural analysis of core samples, strontium isotope analysis and microthermometry on fluid inclusions. This revealed the relationship between the timing of the fracturing and the precipitation of different mineral phases in the fractures by constraining the precipitation conditions and considering the possible fluid transport mechanisms. The core was studied from four different boreholes, located in different structural settings across the LSB. In the core samples from the four boreholes, fractures filled with calcite, quartz and anhydrite were found, in addition to pore‐filling calcite cementation. In boreholes 2 and 3, calcite‐filled fractures have a fibrous microstructure whereas in borehole 1, fractures are filled with elongate‐blocky calcite crystals. Anhydrite‐filled fractures have, in all samples, a blocky to elongate‐blocky microstructure. Fractures that are filled with quartz are observed in borehole 2 only where the quartz crystals are ‘stretched’ with an elongated habit. Fluid inclusion microthermometry of fracturing‐filling quartz crystals showed that quartz precipitation took place at temperatures of at least 140°C, from a fluid with NaCl–CaCl₂–H₂O composition. Melting phases are meta‐stable and suggest growth from high salinity formation water. Strontium isotopes, measured in leached host rock, indicate that, in boreholes 2 and 3, the fluid which precipitated the calcite cements and calcite‐filled fractures is most likely locally derived whereas in borehole 1, the ⁸⁷Sr/⁸⁶Sr ratios from the pore‐filling cements and in the elongate‐blocky calcite‐filled fracture can only be explained by mixing with externally derived fluids. The elongate‐blocky anhydrite‐filled fractures, present in boreholes 1, 3 and 4, precipitated from a mixture of locally derived pore fluids and a significant quantity of fluid with a lower, less radiogenic, ⁸⁷Sr/⁸⁶Sr ratio. Taking into account the structural evolution of the basin and accompanying salt tectonics, it is likely that the underlying Zechstein is a source for the less radiogenic fluids. Based on the samples in the LSB, it is probable that fibrous fracture fillings in sedimentary rocks most likely developed from locally derived pore fluids whereas elongate‐blocky fracture fillings with smooth walls developed from externally derived pore fluids.     

Adult fracture patterns in prehistoric Thailand: a biocultural interpretation

The prevalence and distribution patterns of trauma in samples of human skeletal remains can reflect the risks to which the community was exposed in daily activities or as a result of interpersonal violence. This paper describes the patterns of non‐vertebral fractures in skeletal samples from four prehistoric Thai sites in terms of long bone fracture rates and individual prevalence rates. The sites range in date from c. 2000 BC (Neolithic) to 400 BC (late Bronze Age), and in environment from coastal estuarine to seasonally dry upland plains. These differences in the natural and cultural environment provided a basis for comparison among the samples representing nearly 300 adult individuals. The types of fractures ranged from simple to severe, but most had healed successfully with few limiting complications. The small bones of the hands and feet as well as clavicle and forearm bones were most frequently fractured among all samples. Overall there was an increase in the major long bone fracture rates from the Neolithic (0.3%) to the Bronze Age (3.0%) that may reflect a change in subsistence activities such as land clearance for the intensification of rice agriculture. The prevalence of ulnar fractures is particularly high in the Bronze Age, and the analysis of their possible cause, combined with evidence for craniofacial fractures, is suggestive of the presence of interpersonal violence in a small number of individuals. Copyright © 2006 John Wiley & Sons, Ltd.     

The parry problem

Injuries classified as parry fractures, normally the result of a direct blow when the forearm is raised to shield the face, are significant in bioarcheological interpretations because the parry fracture is perceived as an indicator of interpersonal (or extramural) violence. It is therefore necessary that these injuries be correctly identified in order to properly interpret the trauma pattern and its social implications for abuse, gender and power relations among ancient people. Common acute forearm fractures are reviewed here and quantitative guidelines that define the parry fracture configuration are presented. The parry criteria include: (1) an absence of radial involvement, (2) a transverse fracture line, (3) a location below the midshaft (<0.5 adjusted distance to the lesion's center), and (4) either minor unalignment (<10°) in any plane or horizontal apposition from the diaphysis (<50%). A sample of 278 adults from northern Sudan dated to the Nubian Bronze Age (ca. 2500–1500 BC) contained 38 individuals with forearm fractures. Of these fractures, 21 out of the 28 ulna injuries were identified as parry fractures using the parry criteria. Fewer females suffered from parry fractures than when ulna injuries were identified by location on the ulna alone. The use of the parry criteria may not always affect the results significantly, but here interpersonal violence directed against women and amongst ancient Nubians was found to be less prevalent than implied in earlier studies. The absence of perimortem parry fractures suggests that the Kermans interred within mass burials were not physically forced to their graves. Chronic ulna stress fractures associated with sports and habitual activities must also be considered as a differential diagnosis of this injury.