The prevalence of,and the relationship between some spinal diseases in a human skeletal population from London

The prevalence of osteoarthritis, osteophytosis, intervertebral disc disease and diffuse idiopathic skeletal hyperostosis (DISH) was determined in a group of skeletons excavated from the crypt of Christ Church, Spitalfields. Age-specific prevalence rates were calculated from the group of skeletons for which age at death was known from intact coffin plates. Osteoarthritis of the facet joints occurred most frequently in the cervical and upper thoracic regions and was also common in the lower lumbar spine. The disease was more frequently bilateral in the lumbar spine than in upper regions. Osteophytes were common in the thoracic and lumbar spines, whereas intervertebral disc disease was confined almost completely to the cervical region. Diffuse idiopathic skeletal hyperostosis seemed to be underrepresented in this group, but was more common in males than in females. Age correlated significantly with all the conditions except DISH. Multiple regression analysis was carried out using each of the conditions as the dependent variable in turn. Age accounted for more of the variance than any of the other conditions added as independent variables.     

Spinal pathological findings in ancient Egyptians of the Greco‐Roman period living in Bahriyah Oasis

The spine can provide a large amount of information about an individual's physical condition and possible lifestyle through palaeopathological investigations. The aim of this research was to study spinal diseases among Greco‐Roman ancient Egyptians from Bahriyah Oasis, and to compare them with those from Giza of the Old Kingdom. The material used in the study included 809 single vertebrae and 77 adult sacra of ancient Egyptians from the Greco‐Roman period (332–30 BC) that were excavated from Bahriyah Oasis. The spinal elements were examined for pathological conditions, degenerative diseases, trauma, congenital abnormalities, infectious diseases and neoplasms. The most common lesions of the spine were those due to degenerative processes. The articular facets were more affected than the vertebral bodies. Compression fractures of the bodies, mostly due to osteoporosis, were found in 1.44% and 5.07% of thoracic and lumbar vertebrae respectively. The percentage of spina bifida occulta among ancient Egyptians from Bahriyah Oasis was 62.33%, while among those from Giza was only 3.33%. Few cases of lumbar spondylolysis and one case of DISH were recorded. No cases of infectious or neoplastic diseases were found. Copyright © 2008 John Wiley & Sons, Ltd.     

Erosive peripheral polyarthritis in ancient Japanese skeletons: A possible case of rheumatoid arthritis

The antiquity of rheumatoid arthritis (RA) is still in dispute, due to the difficulty of conclusively differentiating peripheral polyarthritis, especially from spondyloarthropathy, in archaeological populations. In view of the importance of genetic factors in developing spondyloarthropathy and of the far lower prevalence of the disease in modern Japanese, a rarity of peripheral polyarthritis would be anticipated in the ancient Japanese population, given that RA had not been present there. One hundred and sixty adult Japanese skeletons of the late and final Jomon period (3400–2400 years bp ) were examined to find peripheral polyarthritis. There was one male skeleton with peripheral polyarthritis, showing marginal and surface erosions in the joints of the hands, feet, ankle and zygoapopheseal joints of the thoracic vertebrae. RA is suggested as the most probable cause of this pathology. This report raises the significance of further studies to consider whether more cases than anticipated exist in skeletal populations that would have been resistant to developing spondyloarthropathy. Copyright © 1999 John Wiley & Sons, Ltd.     

Spondylolysis in non‐adult skeletons excavated from a medieval rural archaeological site in England

Spondylolysis is studied in a large series of non‐adult skeletons, ranging in age at death from 28 weeks gestation to 18 years old, from the deserted medieval village of Wharram Percy. The aim is to shed light on the age of occurrence of the lesion. Among those with complete lumbar spines, the prevalence of spondylolysis is 0.7%. The prevalence in adults from this group is 12% with no age patterning. Age of occurrence of spondylolysis in this population is inferred generally to be during late adolescent or early adult life. This contrasts with a published study of a modern reference group, unselected for activity patterns or medical complaints, which reported that in most cases spondylolytic defects had already formed by 6 years of age. The Wharram Percy group appeared to resemble rather more the pattern seen today in those involved in strenuous activities, such as competitive sports, both in the relatively late age of occurrence of defects and in the eventual high prevalence. This may be consistent with the observation that, during adolescence, individuals in medieval rural communities were beginning to take on adult tasks which would have been physically strenuous. However, it is unclear why individuals from Wharram Percy did not also form defects in early childhood as modern children appear to. A late age of occurrence appears consistent with published data which suggest a paucity of cases in non‐adults in British archaeological populations. Copyright © 2006 John Wiley & Sons, Ltd.     

A Comparison of Radiological and Palaeopathological Diagnostic Criteria for Hyperostosis Frontalis Interna

Hyperostosis frontalis interna (HFI) is a common clinical finding in post-menopausal women, less often in men. The characteristic billowing symmetrical new bone formation is found on the endocranial surface of the skull and rarely causes any significant symptoms. In clinical medicine HFI is diagnosed from its X-ray appearance, whereas in palaeopathology it is diagnosed by direct observation of the skull. There are no standard palaeopathological criteria to diagnose HFI. In past populations HFI appears to be much less common than today, with modern prevalences of up to 70 per cent of women over 40 affected, compared with archaeological prevalences of between 1 and 4 per cent. This discrepancy has been attributed to a younger mean age at death in ancient populations. This study aims to test the hypothesis that the difference in prevalence may be due in part to the differential nature of diagnosis between the two disciplines. A sample of 85 skulls was X-rayed, and the presence of HFI was recorded using radiological criteria. Using this method the results showed a marked increase in the number of cases of HFI to 31 per cent in females in the ancient population. © 1997 by John Wiley & Sons, Ltd. Int. J. Osteoarchaeol., 7 : 157–164 (1997) No. of Figures: 4. No. of Tables: 3. No. of References: 13.     

Severe vertebral collapse in a juvenile from the graveyard (13th/14th–19th centuries) of the São Miguel church (Castelo Branco,Portugal): differential palaeopathological diagnosis

Diseases that culminate into vertebral collapse are of intricate diagnosis both in palaeopathology and modern clinical practice. When analysing human skeletal remains from the archaeological record this difficulty is amplified due to the absence of complementary medical diagnostic information. This is especially evident when the distinction between tuberculous and pyogenic spondylitis is intended. Taking into consideration this challenging task and based on the macroscopic and radiological study of the skeleton number 8, a specimen exhumed from the East necropolis (13th/14th to 19th centuries) of the São Miguel church, at the Portuguese city of Castelo Branco, the aims of the work here presented are to discuss the range of possible aetiological factors, especially infectious ones, ascribable to the striking pathological changes noticed on this 12‐year‐old individual. These included alterations on the axial skeleton, namely extensive vertebral destruction, presenting as a gibbus deformity, and correlated thoracic deformities. Consubstantiated on palaeopathological and clinical research, tuberculous spondylitis seems to be the most probable cause for the reported lesions. However, the scrutiny between this condition and other pyogenic spinal infections is of extreme complexity when analysing ancient human remains and deserves in‐depth future investigations. Within the framework of the Portuguese archaeological record, the specimen here presented is of major relevance since the pattern and severity of the spinal osseous changes observed were not previously reported. Further, if tuberculous spondylitis is assumed as the most probable diagnosis, the case here presented represents one of the earliest skeletal evidence of this condition in Portugal. Copyright © 2009 John Wiley & Sons, Ltd.     

DNA FROM HUMAN ANCIENT BACTERIA: A NOVEL SOURCE OF GENETIC EVIDENCE FROM ARCHAEOLOGICAL DENTAL CALCULUS

We report a molecular methodology to obtain and analyse ancient bacterial DNA from archaeological dental calculus. Recent and archaeological DNA samples, as old as 4000 bp , were successfully extracted and amplified with species‐specific PCR primers. We propose this approach in order to: detect the presence of specific bacterial species infecting past human populations; compare the composition of ancient oral microbiomes among human populations; and analyse the genetic variability and covariation of bacteria and human host populations. Genomic analysis of bacteria from dental calculus is a promising source of evidence for palaeopathological and micro‐evolutionary studies, focused either on micro‐organisms or their human hosts.     

A Medieval/Early Modern Alpine Population from Zweisimmen,Switzerland: A Comparative Study of Anthropology and Palaeopathology

To date, anthropological comparative studies from Switzerland are rare. Therefore, this research aims to make a comparison between the alpine individuals from Zweisimmen (ca. 14th–19th), and 17 other rural and urban populations from Switzerland all dating to the medieval and early modern period. An osteoarchaeological analysis was carried out on the rural population of Zweisimmen, consisting of 134 skeletons. For each individual, the arm position and orientation were observed in the field, while preservation, representation, sex, age, stature, trauma and pathologies were recorded in the laboratory. These results were compared with data from published and grey literature in order to gain a better understanding of chronological and regional patterns in Switzerland. A chronological development was observed in the orientation, arm position and use of a coffin, which suggests a change in burial practices and beliefs throughout time. The demographic profile represents a natural mortality; however, children and especially neonates are underrepresented in this sample. Some individuals were buried in groups, suggesting simultaneous burial during a period of increased mortality. The palaeopathological findings suggest that the living conditions in rural alpine Zweisimmen were similar to those of other contemporaneous populations, as well as those living in an urban setting. Copyright © 2017 John Wiley & Sons, Ltd.     

A Comparison of Health between Upland and Coastal Late Prehistoric Agriculturists from the Southeast USA

During the late prehistoric period (ad 1250–1550) in the southeast USA, when native populations transitioned to living in permanent, nucleated settlements practicing maize agriculture, most experienced a decline in health. However, some research shows that not all groups experienced the decline in the same way as there were regional differences in dental caries and iron deficiency anaemia frequencies and patterns of physical activity. Therefore, the purpose of this study is to determine if regional differences in health also existed between late prehistoric upland and coastal inhabitants from one part of the southeastern USA. Pathological lesion frequencies were calculated for 441 individuals from 23 upland archaeological sites and compared with previously published data for 340 individuals from 11 coastal sites. Significant differences in lesion frequencies were observed between upland and coastal groups. For example, upland adult men have more carious teeth among the maxillary first incisors, maxillary second molars, mandibular canines, and mandibular second molars. For women, greater caries frequencies are found among the maxillary first and third molars, mandibular first incisors, and mandibular third premolars. Upland children show higher percentages of caries for 14 tooth classes. Coastal juveniles have a greater frequency of porotic hyperostosis, and more of them exhibit an enamel hypoplasia. Periosteal lesion frequency is greater for the coastal group at the humerus, radius, femur, and tibia. Lesions indicative of degenerative joint disease are more often found on the thoracic spinal segment, sacrum and shoulder of upland men with upland women having more lesions at the cervical, thoracic, and lumbar spinal segments, the sacrum, and the shoulder. Taken together, these results show that adults from the upland region consumed more maize and lived a more physically demanding life while coastal adults struggled more with infection. Among children, more coastal inhabitants were anaemic and more of the experienced significant growth disturbances. Copyright © 2013 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.     

Anatomical and Biomechanical Aspects of the Horse Spine: The Interpretation of Vertebral Fusion in a Medieval Horse from Wroclaw (Poland)

The investigation were carried out on the medieval horses thoracic and lumbar spine excavated between 2009‐2011 by the Institute of Archaeology, University of Wroclaw at New Market Square in Wroclaw (Wratislavia, Breslau), capital city of the Polish province of Lower Silesia. The pathological changes, like: ankylosis of the zygapophyses, fusion of the vertebral bodies and arches and the interspinal space calcification were observed. The X‐ray examination was done. During medieval artefact interpretation the biomechanical aspect of horse's locomotor system was taken into consideration. The archaeozoological material was compared with modern horse's spine (with similar pathological changes and known history of disease). The analysis proved, that the observed osseous reaction was a result of the long‐lasting inflammation. Such a disease appearance accompanies chronic inflammatory state of errector muscles of the spine. It is typical for those horses utilised for the saddle. Copyright © 2012 John Wiley & Sons, Ltd.     

Hyperostosis Frontalis Interna and sex identification of two skeletons from the Early Middle Ages necropolis of Vicenne‐Campochiaro (Molise,Italy)

Lesions attributable to Hyperostosis Frontalis Interna (HFI) were examined in two skulls (from graves 100 and 113) from the Early Middle Ages necropolis of Vicenne‐Campochiaro (Molise, Italy). Both skeletons were of older individuals and it was difficult to sex them using standard anthropological methods. We discuss the sex identification of the skeletons in relation to the presence of HFI, as well as the usefulness of this pathological condition as a sex marker, underlining the importance of the relationship between palaeopathological and clinical‐forensic studies. Our study is a further contribution to the case history of HFI in osteoarchaeological material. Copyright © 2006 John Wiley & Sons, Ltd.     

Elongated styloid process in late medieval skeletons from Uzdolje‐Grablje,Croatia

Analysis of skeletons from Uzdolje‐Grablje cemetery near Knin, Croatia, reveals three cases of an elongated styloid process. Elongation is a condition of unknown aetiology characterised by a styloid process that exceeds 30 mm. Although the prevalence of this condition has been reported in modern populations, we document for the first time elongated styloid processes in human skeletal material from an archaeological population. Copyright © 2008 John Wiley & Sons, Ltd.     

Avulsion injuries of vertebral endplates

Bone changes resulting from avulsions involving vertebral endplates have had little, if any, systematic attention in palaeopathological literature. To gain insight into their occurrence and into their variety, two archaeological skeletal collections covering the period AD 1455–1824 were examined. Additional skeletal material was used to illustrate typical examples. A quarter of the 44 adults who had adequate numbers of vertebrae at all spinal levels showed minor to major vertebral endplate changes as a result of avulsion injuries. The male/female ratio was 7:4. The ratio of individuals with injuries contracted during their youth and during their adulthood was 3:8 (n=11). Approximately half of the affected individuals showed such changes in multiple vertebrae. In about one third of the cases, concomitant vertebral fractures, which did not involve the endplates, were recorded. Since the existing classifications of endplate changes from avulsion injuries were developed on the basis of clinical diagnoses made by means of X‐ray or by autopsy, an adapted and extended outline for palaeopathological use is proposed. A series of differential diagnoses is discussed. Although, in general, the poor preservation of archaeological spines hampers epidemiology, the diagnosis of spinal avulsion injuries offers interesting information at the individual level. Copyright © 2000 John Wiley & Sons, Ltd.     

Congenital anomalies of the vertebral column: a case study on ancient and modern Egypt

The aim of this paper is to identify the frequency of congenital anomalies of the vertebral column in ancient Egyptians. The material for this study consisted of 272 skeletons excavated from Giza and belonging to the Old Kingdom (the time of the early pyramid builders). The vertebral columns of these skeletons were examined for the different types of congenital anomalies that affect the vertebrae. Nine cases (3.33%) were affected with spina bifida occulta, while six cases (2.22%) had transitional vertebrae at the lumbosacral joint. These frequencies are compared with other ancient populations. Copyright © 2006 John Wiley & Sons, Ltd.     

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.     

Stafne's defects in two mandibles from archaeological sites in Croatia

Salivary gland inclusions in the mandible are relatively uncommon in recent as well as archaeological populations. This condition is well known to oral surgeons, but less so to anthropologists, osteologists and skeletal biologists. At present a limited number of reports pertaining to this condition in ancient populations are available in anthropological and palaeopathological literature, although scattered reports of cases in recent populations are found in dental journals. This paper analyses the prevalence of Stafne's bone defect in a large composite Croatian archaeological series (n = 4250 mandibles), and reports on two cases in which computerised tomography was performed, in order to draw the attention of anthropologists, osteologists and skeletal biologists to this condition when faced with differential diagnosis of odontogenic lesions, cysts and neoplasms in the area of the angle of the mandible. Copyright © 2009 John Wiley & Sons, Ltd.     

Palaeopathology of Iufaa and other persons found beside his shaft tomb at Abusir (Egypt)

Pathological changes of the lector priest Iufaa are compared with those revealed on the skeletons of his two relatives Imakhetkherresnet and Nekawer, and of an unrelated male Padihor. They were discovered in 2001 in the vicinity of Iufaa's monumental shaft tomb, dating from late 26th dynasty (before 525 BC). The complex was found unmolested by robbers. Congenital anomalies, osteoporosis, degenerative joint changes, post‐traumatic changes and maybe the first palaeopathological evidence of a rare benign neoplasm (neurilemmoma) were recorded. The findings add interesting new facts to the lives of these historical persons. Copyright © 2003 John Wiley & Sons, Ltd.     

A nineteenth-century case of carcinoma of the prostate,with a note on the early history of the disease

A case of prostatic carcinoma is described in the skeleton of a named individual who died in 1834. The tumour was recognized from widespread periosteal new bone throughout the skeleton and by the presence of sclerosing metastases in many bones, including the pelvis and all the vertebrae. A number of features of the disease present here are said to be uncommon in modern patients, including spiculated periosteal new bone and some degree of spinal stenosis. In two previous cases of prostatic carcinoma described in the literature, periosteal new bone was a prominent feature and was probably responsible for the disease being recognized. It is likely that if skeletons from mature males were routinely X-rayed, considerably more cases would be noted and a more accurate estimate of the prevalence of this disease in the past would thus be ascertained. © 1997 John Wiley & Sons, Ltd.