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.     

The effect of parity status on δN: looking for the “pregnancy effect” in 18th and 19th century London

This study examined the effect of parity status on δ¹⁵N using the well-characterised 18th and 19th century skeletal collection from the crypt of Christ Church, Spitalfields, London. We tested whether the cumulative effect of multiple pregnancies and breastfeeding could significantly reduce female δ¹⁵N values compared to males. The results from stable isotope analysis of 92 adult ribs show that the population of Spitalfields had relatively little variation in diet, compared to contemporary urban populations, and had abundant animal and marine protein. We were able to rule out any effect attributable to socio-economic status, date or age at death on the stable isotope ratios. There were no significant differences in δ¹⁵N due to parity status, nor were there any differences between males and females. Models of collagen turnover rates in ribs suggest that the effect of δ¹⁵N depletion due to pregnancy would be undetectable except in ideal circumstances, where bone of the optimal turnover period was sampled, and in cases where multi-parous individuals died shortly after parturition.