Diagnostic criteria for developmental dislocation of the hip in human skeletal remains

Dislocation is the most severe form of developmental dysplasia of the hip (DDH). It significantly impairs hip function in the young, and may lead to debilitating early‐onset osteoarthritis in adults. To our knowledge no thorough study of a large skeletal population has ever been undertaken to determine the wide range of diagnostic criteria for this condition in pathological specimens. To identify these criteria we have analysed the cases of developmental dislocation from a large series of 6000 individuals (6580 hips) from the medieval cemetery at Spitalfields in London, UK. We describe the changes at the true acetabulum, and have created a four‐stage classification of the false acetabulum. The skeletal response to the altered biomechanics and limb shortening that occurs in developmental dislocation is described in the pelvis, lower limb and spine. This includes asymmetric growth in childhood, and asymmetric degenerative change in adulthood. We conclude with a discussion of the clinical literature on developmental dislocation of the hip that will aid palaeopathologists to estimate the symptoms that an excavated individual may have experienced during their lifetime. Copyright © 2007 John Wiley & Sons, Ltd.     

Dysentery in the crusader kingdom of Jerusalem: an ELISA analysis of two medieval latrines in the City of Acre (Israel)

Dysentery was a significant cause of ill health during medieval times according to written sources of the period. However, it has been very difficult to detect the organisms that cause dysentery in archaeological samples from latrines and cesspools. This is because the cysts of the enteric parasites that cause dysentery are very small and usually fragment in the soil, in contrast to the robust ova of parasitic intestinal worms. This study uses a monoclonal enzyme-linked immunosorbent assay (ELISA) technique to identify the fragments of those enteric parasites that cause diarrhoea. Samples were taken from two excavated medieval latrines in the city of Acre. Coins and radiocarbon dating suggest that the latrines were in use during the thirteenth century CE. Positive results were noted for Entamoeba histolytica and Giardia duodenalis, while Cryptosporidium parvum was negative. This is the first time that either of these parasites have been identified in the Middle East using these methods.