Erosive osteoarthritis in a medieval skeleton

In human skeletons from archaeological sites, osteoarthritis is by far the most common disease found, but no case of erosive osteoarthritis has been described and we present here what we believe to be the first such case.     

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.     

Osseous talocalcaneal coalition in a medieval skeleton (ca. 1050 AD)

Tarsal coalition (TC) is defined as an abnormal fusion of two or more tarsal bones. The fusion may be fibrous, cartilaginous or osseous and can be congenital or acquired in response to infection, articular disorders, trauma, neoplasm or surgery. We report a case of a talocalcaneal (TCC) type of tarsal coalition in a medieval skeleton from Northwest Germany dating to ca. 1050 AD. The fusion is of osseous type. Plain AP radiographs and computed tomography confirmed the macroscopic diagnosis. Copyright © 2009 John Wiley & Sons, Ltd.     

A possible case of renal osteodystrophy in a skeleton from medieval Wharram Percy,England

The skeletal remains of a child aged 13–15 years, recovered from Wharram Percy, England, and dating from AD 960–1700, were examined using gross observation, radiography and scanning electron microscopy. Lesions suggestive of renal osteodystrophy were found. Palaeopathological recognition of renal disease has hitherto relied upon the identification of soft tissue lesions or the presence of urinary calculi. This appears to be the first palaeopathological identification of renal insufficiency on the basis of skeletal changes alone. Copyright © 2007 John Wiley & Sons, Ltd.     

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.     

A pituitary tumour in a medieval skull

Evidence of pituitary tumours in osteoarchaeological material is rare. In the present case, an enlarged pituitary fossa in the sphenoid bone indicated an expanding lesion. There was no evidence of hormonal abnormality, and a non-secreting adenoma or, less likely, a craniopharyngioma are suggested as probable diagnoses.     

Age-dependent cortical bone loss in a medieval population

Age-dependent cortical bone loss was studied in a skeletal assemblage from a British medieval site using metacarpal radiogrammetry. Significant loss of bone was found in the females but not in the males. The magnitude of bone loss in the older females relative to their younger counterparts was found to be similar to that reported for modern European subjects. Low cortical bone was associated with healed fractures of the highly trabecular bone of the axial skeleton, and this observation is suggestive that weakening of the skeleton due to loss of bone substance precipitated such fractures, as it does in modern Western women. The broad similarities between the medieval and modern data may call into question the importance of lifestyle factors in influencing the severity of osteoporosis, at least as far as loss of cortical bone is concerned.     

A bipartite patella in a juvenile from a medieval context

One hundred and thirty six well‐preserved medieval skeletons were excavated in advance of re‐development in Norwich. The right patella of a 13–15 year old skeleton (SK 65) displays a ‘fracture line’ running through the supero‐lateral pole. This represents the fusion of a secondary ossification centre, a condition known as bipartite patella. It should not be confused with other anatomical variants or with pathological processes. Copyright © 2002 John Wiley & Sons, Ltd.     

Laws in medieval Iceland

Whereas in eleventh- and twelfth-century western Europe Christianity had taken firm root, monarchy had developed and legislation by royal and ecclesiastical authorities was a normal practice, in Iceland culture remained, for a long period, practically uninfluenced by Roman and canon law. In the present article early Icelandic laws, representatives of this culture, will be described, their formulation and application investigated, and the developments among the establishment of a central authority at the end of the thirteenth century discussed.     

Making the house a home in later medieval York

ABSTRACT

The loss of all original furnishings or decoration and the relentless refashioning of interiors have eroded our ability to appreciate how extant houses functioned as living spaces in the later Middle Ages. This paper uses a variety of documentary sources, notably York’s rich collection of probate inventories, to provide evidence on the division and furnishing of buildings. Depositions from cases within the ecclesiastical court of York ask questions about the way that particular artisanal and mercantile houses functioned both as residences and as places of work. Taking the author’s 2008 study in Medieval Domesticity a step further, the paper will consider in more depth the notion that a distinctive bourgeois ideology of domesticity, which was projected through material culture, grew up in the later medieval city. It will, moreover, ask how far later medieval artisanal or mercantile houses constituted homes.     

Patterns of trauma in a unique medieval parish cemetery

The church and cemetery of St Margaret Fyebridgegate, Norwich were in use from AD 1245 to 1468. The cemetery was used to bury both the parishioners and hanged felons. On excavation, 52 group burials of various sizes were encountered, some containing prone individuals. Four hundred and thirteen inhumations have been examined, of which one-third had evidence of episodes of trauma. Comparison is made of the types of trauma present with evidence from the sites of the Blackfriars, Ipswich and the Mary Rose. Evidence is presented for some possible activity-related trauma at two of the sites.     

Immunological diagnosis of multiple myeloma in a medieval bone

An inhibition enzyme-linked immunosorbent assay using monoclonal antibodies has been used to confirm the diagnosis of IgA type multiple myeloma in a small fragment (< 10 g) of cranium from a medieval female. Further testing by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and immunoblotting showed that the IgA was mainly polymeric, suggesting that the individual would have suffered from a hyperviscosity syndrome. This is the first time that immunological assays have been used to diagnose multiple myeloma in ancient human tissue and have permitted speculation on associated clinical symptoms.     

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.     

Periostitis and osteolysis in a medieval skeleton from South‐West Hungary: (Leprosy,treponematosis, tuberculosis or hypertrophic osteoarthropathy) A diagnostic challenge!

This paper uses macroscopic and radiological examinations to provide differential diagnoses of pathological lesions in the well‐preserved skeleton of a young male from the medieval site of Zalavár in South‐West Hungary. Macroscopic inspection of the skeleton revealed conspicuous thickening of the tibiae and fibulae with ‘tree bark’ appearance of the cortex. Periosteal proliferations are also found on the calcanea and on the posterior part of the femora. The metatarsals showed bony proliferation and bone dissolution. No alteration of the axial skeleton or the skull was noted. Radiographs showed thickening of the cortex of tubular bones due to a multilayered type of periosteal apposition. The likelihood of these symptoms being the result of melorheostosis, hypervitaminosis A, fluorosis, thyroid acropachy, endosteal hyperostosis, tuberculosis (TB), hypertrophic osteoarthropathy (HOA), treponematosis and leprosy is reviewed. None completely explains the entire spectrum of pathological lesions in the current individual, but the individual may have suffered from two co‐existent diseases. As a clinical entity, the changes in the metatarsals are compatible with leprosy, whereas the periosteal proliferations of the lower limbs point to a diagnosis of HOA as a secondary syndrome. Thus, a combination of leprosy and TB is suggested as a potential diagnosis. Although not definitive, our differential diagnosis was able to exclude a number of conditions producing periosteal apposition. Copyright © 2011 John Wiley & Sons, Ltd.