Age-dependent bone loss in the femur in a medieval population

Age-dependent bone loss in femurs in a medieval skeletal assemblage from Wharram Percy, England was studied. Dual energy X-ray absorptiometry (DXA) was used to measure bone mineral density (BMD) in the proximal femur; radiogrammetry was used to measure cortical index (FEMCI) at the femur mid-shaft. Age-related loss of BMD was found in the proximal femur in both sexes. Females but not males showed loss of FEMCI. Patterning in bone loss with respect to age, sex and site in the skeleton resembled that seen in recent subjects. In this respect the results are similar to those of a previous study of metacarpal cortical bone in the same archaeological assemblage. Given the large difference in lifestyles, and that lifestyle factors are widely held to influence the severity of bone loss in osteoporosis, the similarities between the medieval and modern populations in the patterns of bone loss are surprising. These findings support those from an earlier study of these skeletons in calling into question the role of lifestyle factors in influencing the severity of bone loss in osteoporosis. © 1998 John Wiley & Sons, Ltd.     

Metacarpal radiogrammetry: a useful indicator of bone loss throughout the skeleton?

Metacarpal radiogrammetry has received increasing interest in recent studies of archaeological human bone in facilitating the identification of age-related cortical bone loss and osteoporosis risk in the past. The technique is relatively simple and non-destructive, and existing comparative clinical data is an advantage in its application to archaeological samples. In order for metacarpal radiogrammetry to be useful in identifying individuals that could have been at risk of fracture in the past, cortical bone loss as measured at the second metacarpal is assumed to be reflective of bone loss occurring throughout the skeleton and across the metabolically different cortical and trabecular bone. Archaeological studies have frequently relied on literature reviews of clinical data to justify the technique as valid and useful. However, the present study has examined whether cortical bone loss measured in the second metacarpal is similar to bone loss measured at specific skeletal sites that are more frequently affected by osteoporosis-related fracture. Skeletons from two post-medieval collections from London, UK, Redcross Way and Farringdon Street (lower burial ground of St. Bride's Church) were studied. The results of the present study demonstrate that the second metacarpal is useful in identifying age-related bone loss at sites that are predilected to osteoporotic fracture, most notably the distal radius, which is prone to Colles' fractures. Metacarpal radiogrammetry also correlates well with bone loss in skeletal sites that are primarily composed of trabecular bone, including the fourth lumbar vertebra (a site of compression fractures) and the iliac crest (the location for clinical biopsies). The present study also confirms previous findings of significant differences between the pattern of cortical bone loss between the metacarpal and the femur. The poor relationship between these two areas is most likely attributable to mechanical loading.     

An investigation of cortical bone loss and fracture patterns in the neolithic community of Çatalhöyük,Turkey using metacarpal radiogrammetry

Bioarchaeologists have conducted numerous studies on human skeletal remains using metacarpal cortical bone radiogrammetry. This method allows cortical thickness of the second metacarpal to be quantified. As a sensitive index of bone health metacarpal cortical thickness is evaluated in the context of functional adaptations, growth, ageing and bone loss in osteoporosis, as well as used as a reliable indicator of fracture risk. The focus of this study is an examination of the widely used calculation that expresses second metacarpal cortical bone values, followed by an examination of age and sex-related patterns of cortical bone loss and skeletal fragility fracture in a Neolithic archaeological skeletal sample from Çatalhöyük, Turkey. Using metacarpal radiogrammetry, 49 adult metacarpals (f = 27 m = 22) were examined. Data were collected for size variables, length (L) and total bone width (TW) as well as quantity variables, medullary width (MW) and cortical thickness (CT). These parameters were then used to calculate the widely used cortical index (CI) and two new indices expressing medullary width and cortical bone thickness in relation to length (medullary width index, MWI and cortical thickness index, CTI). The ratios were then used to explore age- and sex-related cortical bone loss and fragility fracture patterns amongst the inhabitants of Çatalhöyük. Çatalhöyük males and females demonstrate an inverse relationship where CTI decreases as age and MWI increase. Analyses indicate statistically significant age-related change in MWI amongst the oldest females. Despite age-related loss of bone, no typical fragility fractures are observed. We discuss the role of ageing and lifestyle factors at Çatalhöyük that may have been beneficial to skeletal health and a reduction in the risk of fragility fracture.     

The skeleton of a medieval male with multiple traumatic fractures from Piazza della Signoria,Florence, Italy

We report on the palaeopathology of a medieval skeleton of a young adult male with multiple traumatic fractures found in 1989 in Piazza della Signoria, Florence, Italy. The skeleton presents ante mortem fractures of the right ulna and femur, and left tibia and fibula. We reconstruct the dynamics of the accident based on the location and type of fractures. Then we discuss the impact of this severe trauma on the subject's living conditions based on articular and enthesic modifications of the skeleton. Copyright © 2010 John Wiley & Sons, Ltd.     

Fracture patterns among the Nubians of Semna South,Sudanese Nubia

A collection of 592 individuals from the site of Semna South in Sudanese Nubia was studied for evidence of healed fractures of the skull and appendicular skeleton. The sample included 241 males, 239 females, 109 subadults and three adults for whom a sex could not be determined. Potential analytical and interpretive bias due to vagaries of preservation was quantified and examined. Almost 21% of the adults exhibited at least one healed fracture, while only two subadults showed such trauma. Rates of fractures, calculated for each bone, varied from a high of 17.9% for the cranium to a low of 0% for the right femur. Some fractures were likely caused by the physical environment, for example, falls along the rocky shores of the Nile. Other trauma, such as craniofacial fractures, found in both males and females, may have been due to interpersonal violence. The high rate of craniofacial trauma may indicate that this group experienced social stress which could have precipitated or intensified interpersonal violence. Copyright © 1999 John Wiley & Sons, Ltd.     

Bone weight: new reference values based on a modern Portuguese identified skeletal collection

Skeletal weight and/or weight of the different bones of the human skeleton are currently used in a wide range of applications such as archaeological cremations and forensics. Still, few reference values are available that compare the mean weights for the different skeletal parts. In this paper we present new reference values for total skeletal weight, including the weight of the different skeletal bones based on a modern Portuguese Identified Skeletal Collection (CEI) curated in the Museum of Anthropology of the University of Coimbra (Portugal). The mean weight of the entire skeleton for the CEI pooled sample is 3323.8 ± 779.6 g. Sex and age differences were investigated. As expected, males display heavier bones, at a statistically significant level. The mean weight of the male skeletons is 3850 g, and 2797.6 g for the female sample. Age differences were found, especially for the female samples in the 29–39 versus 50–59 and/or >60 age groups, probably as a consequence of age‐related bone loss in post‐menopausal women. For the male sample, no clear age‐related trend was observed but for the unexpected result that the second highest bone weight recorded is in the oldest age group (>60 years). This could result from high mechanical loadings and thus greater bone robusticy and amount of cortical bone. The percentage of weight of the different parts of the skeleton was also calculated. These new values can be quite useful in the study of very fragmentary and/or commingled human remains, recovered from historic or forensic contexts, since the complete identification, by side, of the remains is not necessary. Copyright © 2008 John Wiley & Sons, Ltd.     

The relationship of bone mineral density and other growth parameters to stress indicators in a medieval juvenile population

In this study the radii of 34 juveniles from Wharram Percy, a British medieval site, were measured for bone mineral density (BMD) using dual energy X‐ray absorptiometry (DXA) in order to investigate evidence of stress including Harris lines, cribra orbitalia and deficient cortical index, which is usually attributed to poor nutrition. BMD measurements are used in modern children to assess growth and development and generally correlate with linear growth. Only rare chronic illnesses affect bone mineral accrual in children. Radiographs of the radii were examined to assess cortical index and of the femora and radii for Harris lines. The results indicate that BMD is well correlated with dental age and linear growth, but is poorly correlated with cortical index. The variability in cortical index indicates the influence of environmental factors. There is no relationship between BMD and the presence or absence of Harris lines or cribra orbitalia. Thus, despite obvious evidence of skeletal stress in this juvenile population, bone was not under‐mineralised and bone mineral accrual proceeded normally with growth. This reinforces the conclusion that cortical index is a more sensitive indicator of environmental stress than either Harris lines or cribra orbitalia, and may be compared with BMD measurements to assess the effect of stress on growth. Copyright © 2005 John Wiley & Sons, Ltd.     

Osteological evidence for the draught exploitation of cattle: first applications of a new methodology

Although the aetiology of bone pathologies in cattle is poorly documented, various deformations in the skeleton have been attributed to draught exploitation in the archaeozoological literature. This paper summarizes the results of an osteological study that was undertaken on the feet of modern draught oxen. This led to the definition of a series of draught‐related anomalies. In an attempt to describe the pathologies in a more consistent and quantitative way, a scoring scale for each individual bone pathology was established. The developed method is applied to cattle remains from four Roman and one late medieval site. The distribution of the observed pathological indices (PIs) on the first phalanges is interpreted in terms of the age structure of the cattle populations, and the possible modes of cattle exploitation and meat consumption in various settlement types. Copyright © 2000 John Wiley & Sons, Ltd.     

Analysis of ante mortem trauma in three modern skeletal populations

When archaeological skeletons are assessed, the prevalence (and patterns of bone involvement) of trauma is important. The number and pattern of fractures can be used to gain insight into the occurrence of interpersonal violence, workload and living conditions. However, the question remains as to how these results should be interpreted—such as what constitutes high or low levels of trauma? The aim of this study was to investigate the occurrence of trauma in a population of modern Greeks living in Crete, as well as South African (SA) whites and blacks in the Pretoria Bone and Raymond Dart collections. The sample comprised mostly of older individuals (n = 90–100 within a sex‐population group). Each skeleton was studied for healed trauma. For the vertebrae, only spondylolysis was assessed. In the Greek sample, it was found that 42% of the males and 46% of females had at least one fracture, with corresponding figures of 63 and 44% for SA whites and 83 and 69% for SA blacks. Radius, rib and femur fractures were most common in Greeks, with skull, radius and ribs most common in SA whites and skull, ulna and ribs in SA blacks. These prevalences of trauma are high, but the composition of the samples (mostly of lower socio‐economic origin) should be kept in mind. It may also be questioned whether these individuals reflect the society as a whole. It seems that the fractures in Greeks are mostly related to old age due to falls and accidents (radius and hip fractures), while the SA black sample reflects high prevalences of interpersonal violence (such as cranial vault and ulna fractures). The SA white sample follows a comparatively moderate pattern of trauma. These comparative figures may be useful when assessing trauma in other skeletal populations. Copyright © 2009 John Wiley & Sons, Ltd.     

Cortical bone dynamics and age‐related osteopenia in a Longobard archaeological sample from three graveyards of the Veneto region (northeast Italy)

Since the contribution of Brothwell and co‐workers in early 1968, few studies have considered the cortical bone involution in European skeletal series of archaeological interest. The present study concerns the involutive process mechanisms and intra‐ and inter‐sexual variability in femurs of 66 adults belonging to three graveyards of the Longobard era excavated in the Vicenza province (northeast Italy). Cortical thickness and cortical and medullary areas were measured and a correlation matrix was generated for each sex and age class. Intra‐ and inter‐sexual variability were evaluated by two‐tailed t‐tests and a sexual dimorphism index. The results indicate a considerable difference between the sexes, with females showing an earlier and more marked cortical bone loss, as expected. Moreover, comparing the data with the scarce literature available, some discrepancies in cortical bone involution were found in populations with different patterns of adaptation, suggesting the need for further studies in this direction aimed at understanding bone environment dynamics. Copyright © 2000 John Wiley & Sons, Ltd.     

Multiple myeloma in an early medieval skeleton

Detailed studies on neoplasms in prehistoric populations are rare. Each well-documented case can therefore add to our knowledge. In former times, palaeopathology could present only tentative diagnoses in the case of tumours. Today, modern diagnostic methods and a comparison with established cases make exact evaluations and their verification possible. During our study it became obvious that criteria for the diagnosis of recent tumours can be used as a guide. In this paper we present the most important findings of a malignant primary bone tumour (multiple myeloma) in an early medieval skeleton and its differential diagnoses. Even in the absence of histological findings, the remaining criteria (X-ray, age, localization, macroscopic features) permit the diagnosis of multiple myeloma to be made with some certainty.     

Bone mineral densities in the prehistoric,Viking‐Age and medieval populations of Norway

Osteoporosis is a prevalent condition in Norway, as evidenced by the fact that this country has the highest reported incidences of hip and distal forearm fractures. Because recent studies suggest a higher bone density in rural populations compared with urban ones, increased physical activity is believed to be an important factor in reducing fracture incidence. In the present investigation, 185 femoral necks from the Schreiner Collection in Oslo were measured by means of a bone‐mass scanner. The bones, anthropological specimens ranging from the Stone Age to the Middle Ages, were separated into three groups: prehistoric (n = 36), Viking Age (n = 38) and medieval (n = 111). The medieval group was further separated into urban, rural and monastic populations. The examination showed that: (a) there was no significant difference at a 5% level in average bone mineral density (BMD) between the male and female material; (b) there was no significant difference in average BMD among the prehistoric, Viking Age, and medieval periods (P = 0.151); (c) there was no significant difference in average BMD between the rural and urban medieval material; (d) there was a significant difference in average BMD only between the monastic and the rural medieval material; (e) only the medieval material showed a significantly higher average BMD than that of today (P = 0.001). These findings may indicate that factors in addition to physical activity are important for normal BMD maintenance. Copyright © 2006 John Wiley & Sons, Ltd.     

Humerus Varus in a Subadult Skeleton from the Medieval Graveyard of La Madeleine (Orléans,France)

The skeleton of a subadult individual from the medieval graveyard of La Madeleine (Orléans, France) exhibits varus deformity of its right humerus. The affected bone is shortened, the diaphysis is angulated and the head is grossly deformed. The skeleton is otherwise normal. Several diagnoses are debated, including mucopolysaccharidoses, thalassemia, infection and trauma, the latter being preferred. The severity of the bone changes suggests that the growth disturbance occurred early in the life of the individual. We therefore suppose that the causative trauma occurred at the time of birth or during the early postnatal period. Copyright © 2011 John Wiley & Sons, Ltd.     

Age‐Related Cortical Bone Maintenance and Loss in an Imperial Roman Population

This article explores age‐ and sex‐related patterns of cortical bone loss, assessed by radiogrammetry of the second metacarpal, from a skeletal sample excavated from the Imperial Roman port city of Velia (1st and 2nd century ad ), to contribute to our understanding of health and disease during the Imperial period. Patterns of age‐ and sex‐related bone loss and health at Velia are also compared with other historical samples and to modern clinical data. It was hypothesised that patterns of age‐ and sex‐related bone loss in this well‐represented Roman sample (n = 71) would mirror those reported in modern populations. Differences in the quantity of cortical bone between three age groups (18–29, 30–49 and 50+ years) are significant in both men and women; however, the pattern of bone loss differs between the sexes. Women show a gradual decline in bone quantity beginning in middle age, whereas men only lose bone in old age. However, there are no significant sex differences at any age group in the metacarpal cortical index. These findings suggest the hypothesis should be refuted because significant sex differences, particularly in old age, are an expected hallmark of bone loss in Western populations today. The possible biocultural and gender‐related factors that may have contributed to the observed patterns of bone maintenance and loss at Velia are discussed. Copyright © 2011 John Wiley & Sons, Ltd.     

A Case of Pituitary Gigantism and Acromegaly in Anatolia (Tasmasor,Erzurum, Turkey)

In 2003, a tall skeleton belonging to a young adult individual was recovered from a post‐medieval cemetery situated north‐east of the modern city of Erzurum, Turkey. The sex of the individual was not possible to determine. The predicted stature values range from 182 to 200 cm with the average 188.94 cm. The growth was proportional on almost all bones, except for the cranial and facial bones. The selected metric data were compared with the mean values of the male individuals from the same cemetery for differential diagnosis. The individual exhibits characteristics of both pituitary gigantism and acromegaly due to the tumour formation developed in the intrasellar area. Pathological features such as severe osteoarthritis, enthesis and new bone formation around and on the joint surface of the post‐cranial bones, kyphoscoliosis and ankylosis are in agreement with these diagnoses as well. Copyright © 2017 John Wiley & Sons, Ltd.     

A case of short‐root anomaly in a female from medieval Istria

Dental examination of a young female skeleton from medieval Istria revealed very short‐roots of both maxillary central incisors. This developmental pathological condition is known in the literature as short‐root anomaly, occurring mostly in maxillary incisors. In affected teeth, the crown:root ratio is 1:1.6. Although the prevalence of this condition has been reported in modern populations, this appears to be the first documented case of the anomaly from the medieval period. Unfortunately, fragmentary preservation of the skeletal material prevents us from making a full diagnosis of possible aetiology. Copyright © 2006 John Wiley & Sons, Ltd.     

A Large‐Scale Palaeopathological Study of Hip Fractures from Post‐Medieval Urban England

Hip fractures have high incidence rates in many current groups and are associated with high morbidity, mortality, and considerable expenditure. Although hip fractures associated with significant traumatic events can occur at any age, many hip fractures occur in older adults. To date, few hip fractures have been reported from archaeological skeletal material, and a number of hypotheses have been suggested for this. This research presents a comprehensive assessment of hip fractures in archaeological bone; 1597 adult (18+ years) skeletons from eight urban post‐medieval sites from England dating from the 18^th and 19^th centuries were recorded, and contemporary medical texts reviewed. This adult sample included 834 males and 652 females as well as 11 persons of undetermined sex. Ways of classifying and describing fractures in the clinical literature were reviewed and a methodology applicable to paleopathology determined. Of this sample, 15 (0.94%) had fractures in the femoral neck or intertrochanteric area: nine males, four females, and two individuals of undetermined sex. The numbers of fractures in males were interesting and most likely represent examples of accidental trauma as well as osteoporosis‐related fractures, the latter receiving growing awareness in recent clinical literature. Overall there was an age‐related trend with more individuals aged 50+ years with fractures than in other age categories. Underlying osteoporosis was potentially a complicating factor in five individuals and was likely associated with a vitamin D deficiency osteomalacia and a metastatic neoplastic condition in a further two cases. Fractures occurring close to the time of death and healed fractures were observed, indicating that the risk of mortality following this trauma was not consistent across this 18^th and 19^th century sample. Skeletal and historical evidence presented in this study indicate that the impact of hip fracture injuries varied, with survival likely linked to the fracture type. Copyright © 2016 John Wiley & Sons, Ltd.     

Do environmental disturbances of an individual's growth and development influence the later bone involution processes? A study of two mediaeval populations

Age‐dependent cortical bone loss was studied in two mediaeval Polish populations differing with regard to socio‐economic status, as well as the intensity of the occurrence of skeletal indicators of living conditions in the early stages of ontogenesis (compression of the skull base and the narrowing of the lumbar vertebral canal). Cortical bone loss was analysed on the basis of the radiographs of the second metacarpal. Cedynia population (better living conditions) is characterized by higher arithmetic means for the height of the skull base in comparison with Słaboszewo group (low socio‐economic status). In the case of the vertebral canal index, significant interpopulation differences apply only to men. Similar patterns of difference between groups under study regarding bone loss was also found. It turned out that males from Cedynia had more bone mass in adultus and maturus age categories; in females, these differences concern only adultus category. The study involved an analysis of a relationship between the characteristics measuring reactions to environmental stress in early stages of growth and the intensity of bone loss in adult life. We believe that the results presented justify a conclusion that both phenomena may be interrelated to a considerable degree. Copyright © 2001 John Wiley & Sons, Ltd.     

Indirect Evidence of Falconry in Medieval Poland as Inferred from Published Zooarchaeological Studies

Although written sources indicate that falconry or hawking was very popular already in early medieval Poland, there is no hard zooarchaeological evidence that would support it. So far, only two studies based on animal remains suggested hawking in medieval Poland. The purpose of this study was to examine all published zooarchaeological reports from all archaeological sites in Poland and check for possible clues of hawking. Altogether, 281 remains of 12 species of diurnal birds of prey were recorded from 38 sites (49 time‐site units) in Poland beginning from the Middle Ages onward. The most frequently found was the goshawk Accipiter gentilis followed by the white‐tailed eagle Haliaeetus albicilla and the sparrowhawk Accipiter nisus. Clues of possible hawking include high status of sites, occurrence of species used in falconry outside their natural ranges, preponderance of females, the presence of sub‐adult specimens and others. It is suggested that surface damage observed on prey bones done by the hawks' beaks and claws may be an extra evidence of hawking. The present study strongly supports the notion that hawking was a very popular activity in medieval Poland. In the future, medieval bone assemblages should always be checked for clues of hawking. The present study may also be used as a source of raw data for other analyses because it includes detailed information on birds of prey from all zooarchaeological reports published so far in Poland. Copyright © 2015 John Wiley & Sons, Ltd.     

A Possible Case of Hydrocephalus in a Medieval Child from Doonbought Fort,Co. Antrim,Northern Ireland

Hydrocephalus is a condition that is rarely found in the palaeopathological record. It has been demonstrated in a modern study of untreated cases of hydrocephalus that 50 per cent of children suffering from the disease die within the first 18 months of life. It is probable that the situation was the same in archaeological populations and that the delicate nature of neonatal and infant crania accounts for the paucity of palaeopathological evidence. As far as the author is aware there are approximately 30 possible cases of hydrocephalus known in the archaeological record throughout the world and only two of these cases originated in the British Isles. The following report presents evidence of a case of possible hydrocephalus in a 6–7-year-old juvenile from Northern Ireland. The skeleton was recovered from a post-thirteenth century context during excavations at the secular medieval fort of Doonbought, Co. Antrim. The diagnosis of hydrocephalus has been made on the basis of the abnormal and enlarged morphology and increased cranial capacity of the cranium. The only other palaeopathological lesion present in the remains was cribra orbitalia.