Diaphyseal remodelling in leprosy: A radiological and palaeopathological study

Diaphyseal remodelling is a pathological process of the proximal phalanges, metatarsals and metacarpals in all established types of clinical leprosy. It is suggested that the changes are the result of sympathetic neuropathy and alteration of peripheral vascular bed dynamics selectively stimulating extracortical osteoclastic and endosteal osteoblastic activity. There is an overall loss of diaphyseal cortical diameter, either in concentric or knife-edge pattern. There is extracortical absorption of bone and coincident endosteal bone deposition. Ultimately, there is diaphyseal pathological fracture, and subsequent resorption of the distal and proximal remnants due to combined continued diaphyseal remodelling and achroosteolysis.     

Septic bone changes in leprosy: A clinical,radiological and palaeopathological review

Infective lesions of bone in leprosy are of two types. In the rhinomaxillary syndrome, superficial infective changes in the bones of the maxilla are due to the presence of Mycobacterium leprae. Lytic foci in the medulla or the outer cortical surface may be due to Mycobacterium leprae at the site as granulomatous lesions. The most frequent infective bone changes in leprosy are, however, sequelae of regional anaesthesia and soft tissue ulceration. The bone lesions are due to pyogenic bacteria and the nature of these infective lesions is similar to that in non-leprous conditions. The pyogenic lesions in leprosy are restricted to the bones of the hands, feet and lower legs.     

A case of Os odontoideum in the palaeopathological record

Os odontoideum is an uncommon abnormality of the second cervical vertebra, the aetiology of which is contentious. Whether congenital or acquired, the condition often results in atlantoaxial instability and subsequent compression of cervical cord or vertebrobasilar vessels. The bioarchaeological study of a medieval sample from the Christian necropolis of Cacela Velha (Algarve, southern Portugal) provided the opportunity to describe one of the first cases of this rare anomaly ever reported in the palaeopathological record. Copyright © 2007 John Wiley & Sons, Ltd.     

Variable nucleotide tandem repeat (VNTR) typing of two palaeopathological cases of lepromatous leprosy from Mediaeval England

Using ancient DNA methods, we have examined in detail two archaeological cases of leprosy from Mediaeval England. The first was a child skeleton with rhino-maxillary changes typical of lepromatous leprosy (LL). The second case was the skeleton of a male adult who showed both typical rhino-maxillary changes and osteitis/periostitis on the leg and foot bones. Bone powder was sampled from both cases and DNA extracts were prepared. These were subjected to a series of polymerase chain reactions (PCRs) specific for regions on the Mycobacterium leprae genome. The repetitive element RLEP was used for confirmation of M. leprae DNA and then three polymorphic regions were successfully amplified and sequenced to determine the number of variable nucleotide tandem repeats (vntr) at these loci. These were the microsatellite regions ML2344 and ML2172 and the minisatellite region ML0058. Genotyping data from the strains preserved within the skeletal remains were compared with those obtained for a reference strain of M. leprae. Variation at these three loci was found between both burials and the reference strain, indicating that vntr typing of LL cases from the archaeological record is a useful way of confirming disease and an additional means of authenticating aDNA data. This demonstrates the feasibility of targeting multiple loci for phylogenetic studies of leprosy strains from archival sources.     

A palaeopathological investigation of the third intercondylar tubercle of Parsons

The third intercondylar tubercle of Parsons (TITP) is a bony protuberance which is sometimes present on the tibial plateau. It corresponds to the insertion of the anterior fibres of the anterior cruciate ligament (ACL). Reasons why TITP is present in some knees and not others are at present unclear. TITP is studied in knee joints from 68 adult individuals from a medieval cemetery. Associations are investigated with age, sex, knee osteoarthritis, clinical and subclinical DISH, and skeletal signs of trauma, with the aim of evaluating existing ideas on the causation of TITP. Only trauma showed an association with the presence of TITP. The results offer support for the aetiology of trauma to the ACL in the formation of TITP. Copyright © 2008 John Wiley & Sons, Ltd.     

Flatfoot: the palaeopathological diagnosis

Bipedal human motion is related to the original shape of the foot. Distortion and degenerative changes may be caused by failure in the complex chain of movements. There are few references to valgus flatfoot in either the palaeopathological or medical literature. The study of three French medieval series (Macon, Larina and Cutry) in the osteological collections of the CEPAM (UMR 6130 – CNRS/UNSA) at Valbonne (France) enabled us to define several significant osseous signs which provide evidence of abnormal biomechanical constraints following structural change in the foot. The consequences of the change of axis of the talar pulley, abnormal osseous contacts, and evolutionary modifications noticed in some synostoses of the tarsus, are particularly useful for study. Analysis of the location of arthritic change in the joint may produce an additional coherent argument to the diagnosis. The recognition of flatfootedness in an archaeological context provides a marker of health and of distress, which is all the more interesting since bones required for this diagnosis are often present and relatively well preserved in the excavations of burials. Copyright © 2006 John Wiley & Sons, Ltd.     

Fitzroy's fighting Fuegians: Comparison of palaeopathological and ethnographic indications of fighting behaviour in an extinct human population

The Selk'nam were an indigenous population of Tierra del Fuego that are now extinct. Contemporary accounts, including those of Robert Fitzroy and Charles Darwin, attest to their prodigious size and strength. These accounts and others record that the Selk'nam were enthusiastic wrestlers and fought till one or other of the opponents could no longer continue. Presented here is a case of traumatic injury to the ulnae and radii of a Selk'nam male that is concomitant with injuries sustained during such activity and as such would provide intriguing evidence of this practice in the skeletal record of an extinct human population. Copyright © 2010 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.     

A palaeopathological study of Colles' fracture

This work is an osteological study of four cases of Colles' fracture from a 3rd–4th century AD British archaeological site. Each case was from an elderly female. Investigation of the degree of malunion suggests lack of effective reduction for these fractures. The poor anatomical outcome appears generally to have resulted in poor functional outcome; detailed anatomical study provided evidence for impairment of function of the distal radioulnar joint, ulnocarpal abutment and scapholunate diastasis, conditions which would probably have caused long‐term residual disability. Copyright © 2006 John Wiley & Sons, Ltd.     

Syndactyly in Pigs: A Review of Previous Research and the Presentation of Eight Archaeological Specimens

This paper reviews evidence for the rare condition of porcine syndactyly. It describes eight archaeological examples from Britain, Northern Ireland and France. Syndactyly refers to the partial or complete fusion of two or more adjacent phalanges on the medio‐lateral border. The degree and character of fusion are variable, but phalanges frequently unite to create a single skeletal element. This condition has been identified by veterinarians, zoologists and naturalists in individuals and populations in a range of species, but in spite of substantial research on the condition in humans and to a lesser extent cattle, it remains relatively poorly understood in other mammals. Syndactyly is generally agreed to be primarily congenital in origin, although factors affecting its incidence remain far from fully understood. In light of the general paucity of discussion of specific conditions of animal palaeopathology, this paper presents an analysis of these newly discovered syndactyle pig specimens, offers a review of research with particular reference to pigs and discusses the etiology of the condition. Copyright © 2011 John Wiley & Sons, Ltd.     

Infancy and childhood in the pre‐Columbian North American Southwest–first results of the palaeopathological investigation of the skeletons from the Grasshopper Pueblo,Arizona

Infant and child skeletons (n = 369) from the pre‐Columbian Grasshopper Pueblo site in east‐central Arizona (US) dating from the 14^th century AD were examined macroscopically and with low‐power microscopy. They were studied as a representative example of a typical Mogollon community with respect to frequencies of deficiency and inflammatory diseases. First results revealed very poor living conditions, which are characteristic for this time period in the North American Southwest because of lack of food due to climatic and political changes. Thus, non‐specific stress indicators were frequently observed. In the group of deficiency diseases, anaemia was found in more than 50% of individuals, and in the group of inflammatory diseases, meningeal irritations were diagnosed in more than 70%. Copyright © 2007 John Wiley & Sons, Ltd.     

Cleft palate: a case study of disability and survival in prehistoric North America

This study presents an analysis of an adult male that demonstrates diagnostic markers of cleft palate. The burial is associated with the Grider Site, Late Woodland context (AD 500 to 1000), located in Pike County, Indiana, USA. The analysis draws on clinical and palaeopathology literature to consider other possible conditions responsible for the skeletal anomalies. Cleft palate occurs in about one in 1000 live births, and is one of the most common defects of the face. Despite the high frequency of cleft palate, few cases are reported from the archaeological record. It is possible that, in the past, few infants survived extreme forms of cleft palate, and such cases are not present to be recorded. Or, it is possible that the lesion simply goes undocumented. This analysis outlines the markers of cleft palate in this individual and demonstrates that a prehistoric culture could overcome the health issues experienced by an infant with the condition (full communication between the oral and nasal cavities) and survive to adulthood. Copyright © 2006 John Wiley & Sons, Ltd.     

Mycobacterium leprae genotype amplified from an archaeological case of lepromatous leprosy in Central Asia

We have amplified Mycobacterium leprae DNA from the skeleton of an adult human female exhibiting signs of lepromatous leprosy (LL). The remains were excavated from the site of Devkesken 6 on the Ustyurt plateau of Uzbekistan and date to between the 1st and 4th centuries AD. Recovered DNA was fragmented but of sufficient quality and quantity to allow a series of biomolecular genotyping methods to be applied. These methods included variable nucleotide tandem repeat (VNTR) typing of two microsatellite and one minisatellite regions and also single-nucleotide polymorphism (SNP) typing for nine informative loci.Genotyping showed that the causative strain of M. leprae exhibited a SNP-type 3 profile, characteristic of cases associated geographically with Europe and North Africa. Further SNP sub-typing was performed and the data obtained from the Uzbek leper was compared with the same loci amplified from a case of LL recovered from Blackfriars, Ipswich, UK dating to between the 13th and 16th centuries AD. Unique group 3 subtypes were found in both the Uzbek case and Ipswich 1914. These appear to be ancestral to recent type 3 strains. Mycolic acid analysis confirmed the presence of M. leprae in the Uzbek samples. Phylogenetically informative SNPs and other polymorphic loci will contribute to the study of human migrations, as well as the origin and spread of leprosy.     

The EB IA tombs and burials of Bâb edh‐Dhrâ, Jordan: a bioarchaeological perspective on the people

The transition from a hunting/gathering economy to an agricultural economy, beginning about 10,000 years ago, was accompanied by the development of specialised innovations including nomadic pastoralism. It was also associated with the emergence of increasingly sedentary human societies in which relatively large numbers of people lived in a crowded urban environment. The dynamic relationship between agriculture and urbanisation undoubtedly had a profound effect on evolutionary dynamics in developing complex human societies. By the beginning of the Early Bronze Age (EB IA, ca. 3300 BCE) an agricultural economy was well established in the region surrounding Bâb edh‐Dhrâ, located in the southeastern plain adjacent to the Dead Sea in Jordan. However, the site apparently did not begin to develop as an urban centre until EB IB. The objective of this paper is to explore what is known about the EB IA people of Bâb edh‐Dhrâ. The presence of infectious and metabolic diseases coupled with high infant mortality and low life‐expectancy at birth suggest a society at risk. Nevertheless the people were robust and give evidence of at least a moderately successful adaptation to the environment in which they lived. Published in 2007 by John Wiley & Sons, Ltd.     

The Chalcolithic burial cave in Ma'avarot,Israel, and its palaeoanthropological implications

This paper reports on bioarchaeological and palaeopathological investigations of the Chalcolithic Ma'avarot burial cave in the Hefer valley (Sharon central coastal plain), Israel. The objective of this project was to retrieve enough data from the anthropological material which, in conjunction with the rest of the archaeological record, would help to better elucidate aspects of the archaeological questions concerning the Chalcolithic in the Levant. The integrated analysis of the archaeological record included studies of burial customs and practices, the associated material culture, skeletal biology, pathology and bone archaeometry. Correlations are made with the current and contradictory arguments about the migration of peoples and cultural diffusion and the explanatory hypothesis supporting autochthonous cultural developmental processes at this chronological juncture in the Levant. © 1998 John Wiley & Sons, Ltd.     

Palaeopathology at the Khan-el-Ahmar site: Health and disease in a Byzantine monastery in the Judean Desert,Israel

The present study describes the skeletal material that was uncovered at the crypt of the monastery of St Euthymius at Khan-el-Ahmar, in the Judean Desert, near Jerusalem. Comparative morphometric analysis with contemporaneous populations and the palaeodemographic and palaeopathological data disprove many historians' well accepted notions regarding early Christians in the Judean Desert. In the present paper we suggest that the majority of people who were buried at the Khan-el-Ahmar monastery derived mainly from the autochthonous population of the region and were not migrants or fugitives from surrounding countries. It appears that this community of monks lived in a rather protected environment despite their desert surroundings. In the monastery, they maintained a high level of personal hygiene, had adequate food supplies and were not subjected to repeated acts of violence from their neighbours.     

A possible case of hyperparathyroidism in a burial of 15–17th century AD date from Wharram Percy,England

The subject of this paper is the partial skeleton of an adult female, dating to ad 1420–1640, excavated from the church at the deserted village of Wharram Percy, North Yorkshire, UK. Lesions are described which are probably indicative of hyperparathyroidism. Copyright © 2001 John Wiley & Sons, Ltd.