Congenital Syphilis in the Archaeological Record: Diagnostic Insensitivity of Osseous Lesions

The paucity of convincing evidence for congenital bone lesions of syphilis in the archaeological record led to study of the human remains from the Buffalo site in West Virginia, dated at 550—650 years BP. The diagnosis of syphilis (venereal) in adults was based on previously validated population criteria for the recognition of syphilis and its distinction from among the other treponemal diseases. Among the 151 juveniles (23.3 per cent of the total series), only one had macroscopic evidence of periosteal disease. The low frequency of recognizable osseous stigmata characteristic of congenital syphilis, combined with the conspicuous absence of pathognomonic dental lesions, make such periosteal lesions insufficiently sensitive criteria for the identification of syphilis in the archaeological record. © 1997 by John Wiley & Sons, Ltd.     

Identification of tarsal coalition and frequency estimates from skeletal samples

Tarsal coalition is a congenital defect that results when adjacent tarsals fail to separate properly during embryonic development. Anatomically, coalitions present as non‐osseous bridges of cartilage or fibrocartilage – and occasionally as osseous bridges – between two neighboring bones. In skeletons, non‐osseous tarsal coalitions are recognizable as matching lesions between two bones at predictable locations. These coalitions are of interest because they are known to be heritable and are therefore useful for tracing genetic relatives in archaeological cemeteries, because they can be misinterpreted in skeletons as trauma or joint disease, and because they can result in associated pathology. However, despite a considerable literature on tarsal coalition, estimates of coalition frequencies disagree considerably, perhaps due to biases inherent in clinical sampling. In order to gain a better estimate of tarsal coalition frequencies in human populations, data were gathered on 342 European‐Americans from the Terry Collection (Smithsonian Institution), 536 South Africans from the Dart Collection (University of Witwatersrand, South Africa), and 756 medieval Danish skeletons (Anthropological Database, Odense University). The Danish skeletons are archaeological, with sample sizes by coalition type ranging from 366–507 individuals. Examples of eight different types of intertarsal coalition were identified among the 1634 skeletons examined. Overall frequency estimates for tarsal coalition ranged from 2.1%–3.5%. South Africans exhibited significantly higher frequencies in the midfoot, with naviculocuneiform I coalition (1.0%) the most common type. Conversely, no coalitions of the midfoot were found among the Euro‐Americans or medieval Danes. Instead, these groups exhibited calcaneonavicular coalition as the most common type in the hindfoot (2.0% and 2.1% respectively), while calcaneonavicular coalition was among the least common in the South Africans (0.2%). Copyright © 2010 John Wiley & Sons, Ltd.     

Hard core and cutting edge: experimental manufacture and use of Magdalenian composite projectile tips

The technology of the European Upper Palaeolithic yielded abundant evidence of the use of composite projectile heads, in the form of osseous points on the side of which one or several (micro)lithic elements are attached. Yet, little experimental work has been devoted to testing and assessing the parameters of use of this type of composite tips. In this paper we present a pilot experiment with replicas of Magdalenian composite spear tips, made of an antler point with one or two rows of flint backed bladelets. Two series of replicas were manufactured after the lithic and osseous record of, respectively, the Lower Magdalenian from southwest France (c. 20–18 Ky cal BP) and the Upper Magdalenian of Pincevent in the Paris Basin (c. 15–14 Ky cal BP). The 34 experimental composite heads were hafted to spears that were then shot with a spearthrower at the carcasses of two young deer. The results provide some insight into the performance characteristics of the osseous and lithic components, both in efficiency and durability. Finally, possible improvements of the experimental protocol are discussed, as well as the implications of our results for the understanding of projectile point variability in the Upper Palaeolithic.     

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.     

Skeletal metastatic carcinoma: A case from 15th–20th century Coimbra,Portugal

This paper discusses the differential diagnosis of unusual and distinct pathological changes in the skeletal remains of a 40+‐year‐old female from 15th–20th century Coimbra (Portugal). The most affected area seems to have been the skull, but multiple lesions, lytic and/or blastic, have been found throughout the post‐cranial skeleton, more specifically in the scapulae, clavicles, humerus, sternum, ribs, sacrum, innominates and femurs. The differential diagnosis of the lesions gave rise to several possible pathological conditions, namely, Langerhans cell histiocytosis (granulomatosis or Histiocytosis X), multiple myeloma and metastatic carcinoma. Various macroscopic and radiological aspects lead us to consider metastatic carcinoma as the most probable diagnosis. Despite the argumentative identity of the possible primary lesion, age, sex and the mixed nature of the osseous response are consistent with cancer of the breast but do not exclude other carcinomas, namely lung cancer. With temporal and regional differences emerging in the frequency of malignant tumours, the identification of new cases becomes important, particularly from geographic areas where few cases have been reported. In fact, the present report adds to the only case of metastatic carcinoma detected in non‐identified Portuguese human skeletal remains until now. Copyright © 2009 John Wiley & Sons, Ltd.     

A probable case of metastatic carcinoma from the late prehistoric eastern Tennessee River Valley

There are few described cases of metastatic carcinoma from the prehistoric eastern United States and none primarily differentially diagnosed from the southeast. A mature adult female exhibiting several large lytic cranial lesions suggestive of neoplastic disease was identified in a late prehistoric Mississippian Period (AD 1200–1600) context. Burial 371 is from Ledford Island, a Mouse Creek phase (AD 1400–1500) site from the Chickamauga Reservoir of southeastern Tennessee. It is the only case in this reservoir (total adult n = 843). The radiographs of the otherwise asymptomatic postcranium yielded radiolucencies in both proximal femora, both medial clavicles, the sternum, the surviving humeral metaphysis and fragmentary innominate. The locations are all consistent with metastasized carcinoma. The identity of the possible primary lesion is argumentative. Age, sex and the mixed nature of the osseous response are consistent with carcinoma of the breast but not to the exclusion of bronchogenic, thyroid, or kidney cancers. Copyright © 2002 John Wiley & Sons, Ltd.     

Benign mandibular tumours: Two case studies from the Maya lowland site of Tikal,Guatemala

This study presents a differential diagnosis of benign mandibular tumours identified in two adult burials from the precontact Maya city of Tikal, Guatemala. Both individuals were recovered from domestic structures that date to the Late Classic Period (AD 550–850). The osseous growths were interpreted as probable benign tumours based on evidence of localised growth, a circumscribed border, a dense texture and a lack of osteolytic activity or spiculate bone formation. Burial PTP‐026A is a middle adult (35–50 years) of indeterminate sex with evidence of a small dense, circular mass extending laterally from the right mandibular corpus. Macroscopic and radiographic assessment of this lesion provided a diagnosis of osteoma, a true neoplasm, or alternately, hyperplasia (e.g. exostosis) or hamartoma, which are not true neoplasms. Burial PTP‐017 is a probable young adult female (20–35 years) with a large osteoblastic lesion on the right anterior mandibular corpus. This dense, bony mass extends from the anterior margin of the mental canal, and shows a distinct boundary from the adjacent trabecular and cortical bone. The growth of the osseous mass displaced the right first premolar anteriorly. Radiographic assessment showed the presence of dense, radiopaque material, indicating significant calcification. This suggested a likely fibro‐osseous origin for this lesion, with a probable diagnosis of ossifying fibroma, or possibly osseous dysplasia. Although not definitive, our differential diagnosis was able to exclude a number of neoplastic and non‐neoplastic conditions that affect the jaws. This study provides the first reported cases of possible benign mandibular tumours in the ancient Maya. Copyright © 2009 John Wiley & Sons, Ltd.     

Pre-Columbian congenital syphilis from the late antiquity in France

Today, exactly 500 years after the discovery of America, there is still a lot of controversy about the history of syphilis in Europe, especially about the Columbian and pre-Columbian hypotheses. This paper presents evidence for the presence of venereal treponematosis in the late Antiquity in France. The case that we examined comes from the necropolis of Costebelle (3rd-5th centuries AD; Hyères, Var, France). Grave no. 1 contained the well-preserved skeleton of a relatively old woman with the skeletal remains of an approximately 7-month-old fetus in her pelvic cavity. The osseous lesions of the fetal remains can be described in four groups: periosteal appositions on the skull vault (frontal and parietal); signs of periostitis on the long bones (bilateral cortical irregularities, predominantly on the left side, which affect first of all tibiae, femora, fibulae, radii and humeri, particularly in the metaphyseal region); some infraperiosteal detachment reminiscent of an infraperiosteal haematoma surrounding the distal extremity of the left forearm and the left hand; and finally, the irregular lesions of the humeral distal and proximal tibial metaphyses reminded us radiologically of Wimberger's signs. The most probable diagnosis of all the lesions mentioned above is that of a precocious congenital syphilis. This case consists of an argument against the epidemiological theories about the migration of Treponema pallidum from the New World back to the Old World starting at the end of the 15th century.     

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.     

Non‐osseous calcaneonavicular coalition in the Portuguese prehistoric population: report of two cases

This paper reports articular surface defects detected in three foot bones. These were exhumed from Portuguese collective burial places, Hipogeu de São Paulo II (artificial cave, Almada) and Necrópole da Serra da Roupa (shelter, Columbeira) dated to the Late Neolithic and Chalcolithic periods. Other aetiologies were presented, but non‐osseous calcaneonavicular coalition proved to be the most probable explanation for the unusual morphology detected in two calcanei and one navicular bone. Copyright © 2005 John Wiley & Sons, Ltd.     

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.     

Anthropological analysis of the phenomenon of atlas occipitalisation exemplified by a skull from twardogóra (17th c.)—southern Poland

Occipitalisation of the atlas is one of the most frequent osseous anomalies of the atlas. It is characterised by the adhesion of the first cervical vertebra with the basilar part of the occipital bone. The most probable cause of the occipitalisation is a congenital disorder. The atlanto‐occipital fusion may lead to narrowing of the space for medulla oblongata, spinal cord and vertebral artery. This in turn may lead to many physiological symptoms. The skull from Twardogóra, Southern Poland, showed partial atlanto‐occipital fusion and presented an asymmetry in structure and shape of apertures for the vessels and nerves around the foramen magnum. Copyright © 2011 John Wiley & Sons, Ltd.     

Spotted hyena (Crocuta crocuta) den use and taphonomy in the Masai Mara National Reserve,Kenya

Hyena taphonomy is of great importance to studies of hominid evolution, since these carnivore taxa have the highest potential both to produce large osseous assemblages and to modify existing hominid-accumulated assemblages throughout the Old World. The three extant hyena species (brown: Parahyaena brunnea; striped: Hyaena hyaena; and spotted: Crocuta crocuta) are all significant bone collectors and modifiers. Spotted hyenas generally have the lowest potential to accumulate osseous remains, and the rate of accumulation varies based upon the type of den. The present research examines the remains accumulated by spotted hyenas in Masai Mara Cave, Masai Mara National Reserve, Kenya. The contents of this den were collected twice by the authors, with an 11-year span interceding. The taphonomic signatures of spotted hyena interaction with bone are presented, including species and skeletal element representation, breakage patterns, tooth marks, tooth puncture, edge polish, and gastric corrosion. Other taphonomic factors examined include rodent gnawing and weathering stage. The cave den assemblage was accumulated at a rate of 30.4 identified specimens and a minimum of 4.1 prey individuals per year. In addition, the osseous remains accumulated by spotted hyenas at multiple burrow dens within the Reserve were examined for taxonomic representation and multiple taphonomic parameters. Rates of accumulation at this type of den tend to be very low, due to differential usage by spotted hyenas and the more ephemeral nature of earthen dens.     

A cripple from the medieval hospital of Sts James and Mary Magdalen,Chichester

The skeletal remains of a medieval leper from the hospital of Sts James and Mary Magdalene, Chichester, demonstrate osseous alterations in possible response to altered posture and crutch-aided locomotion. This individual provides further insight into the possible identification of osseous changes commensurate with maintained abnormal posture and strenuous use of one limb to aid locomotion. In this regard, it allows an appreciation and assessment of skeletal plasticity as a possible response to trauma and disease processes.     

Slipped proximal femoral epiphysis in a priest from the medieval period

During the course of a routine analysis of a cemetery burial population associated with the medieval hospital of St Giles, Brough, North Yorkshire, the partially excavated burial (No. 1423) of a priest, as identified through the associated chalice and paten dating to the medieval period, was observed to exhibit osseous changes commensurate with those of an untreated slipped proximal femoral epiphysis. Secondary osseous changes were noted that may indicate habitual positional behaviour subsequent to the injury.     

Multifocal eosinophilic granuloma with a possible trepanation in a fourteenth century Greek young skeleton

Multiple lytic lesions in the cranial remains of a young adolescent from medieval Corinth in Greece, display characteristics best associated with multifocal eosinophilic granuloma. Some of the lesions have marginal sclerosis indicative of healing. The lesions vary in size from less than one centimeter in diameter to over two centimeters. The larger lesions, in particular, appear to be the result of confluence between two or more lytic foci. These lesions, rarely described in archaeological skeletal material, result from a pathological disturbance within the reticuloendothelial system. One of the cranial lesions has a different appearance from the other lesions and may have been produced by a therapeutic trepanation. © 1997 John Wiley & Sons, Ltd.     

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.