Possible rheumatoid arthritis found in the human skeleton collected from the tomb of Joseon Dynasty,Korea, dating back to the 1700s AD

We report a possible rheumatoid arthritis (RA) case found in a Korean Joseon Dynasty (1392–1910) tomb encapsulated by a lime‐soil mixture barrier (LSMB). The tomb is thought to have been constructed during the 1700s AD (1760 AD by carbon dating). In our anthropological examination, joint destruction, erosion or fusion (signs of polyarthritis) were identified mainly in the peripheral skeleton. Especially in both sides of the wrist bones, severe destruction/joint fusion possibly caused by polyarthritis was observed. A similar polyarthritis pattern also was seen in the right foot bones, even though we failed to confirm this symmetry due to the missing left foot bones. Despite these findings, signs suggestive of polyarthritis are very rarely seen in axial bones, even though bony fusions are found in the atlanto‐occipital joint or thoracic vertebrae (TV) 9–10. By the osteological signs observed in this case, the individual, a female, might have been suffering from a very late stage of RA and died in her 40s, even though other forms of chronic arthritis could not be ruled out completely. Though the current case could not provide evidence to decisively settle the debates on the antiquity of RA, our report could be a stepping stone for forthcoming studies on RA cases found in East Asian countries. Copyright © 2009 John Wiley & Sons, Ltd.     

Diffuse idiopathic skeletal hyperostosis cases found in Joseon Dynasty Human Sample Collection of Korea

Diffuse idiopathic skeletal hyperostosis (DISH) is a disorder showing hyperostosis of the spinal column and ossification of extraspinal ligaments or tendons. The prevalence of DISH has been found to be higher in historic peoples of the upper‐ and ruling classes, and in fact was closely correlative with nutritional and high‐caloric diets. DISH is also known to be a function of genetic factors; as such, there have been very few cases of DISH found among the specimens of Asian skeletal collections. In our osteoarchaeological study on the Joseon Dynasty Human Sample Collection (JDHSC), we found four DISH instances among the 96 cases (4.17%) we examined. This prevalence is not so different from those discovered in already‐published studies on collections in Europe and other regions. However, as already stated, it must be considered that most of the JDHSC individuals we examined were remains of people from the highest social classes of 16th–18th century Joseon society. Therefore, when collections from medieval European monastic sites, the appropriate control from well‐fed populations, were used for comparison, the prevalence of DISH was found to be far lower among the JDHSC. Reports on DISH from examinations of collections in Asian countries have been spotty, leaving gaps in the social‐strata spectrum. Further researches into the prevalence of DISH among the different social strata of ancient or medieval Asian peoples are still required. Copyright © 2010 John Wiley & Sons, Ltd.     

Knee Ankyloses Associated with Tuberculosis from the Medieval Hungary – Differential Diagnosis Based on Medical Imaging Techniques

Osseous ankylosis of large joints that occurs secondary to infection is rarely described in developed countries, thanks to diagnostic techniques that allow early detection and treatment of the underlying infection. Evidence of the natural history and progression of the disease is now primarily studied through the observation and analysis of osteoarcheological specimens, and medical reports or books dating from the pre‐antibiotic era. This report illustrates several cases where modern medical imaging techniques and ancient medical literature were successfully interpreted to diagnose rare, advanced‐stage tuberculous alterations in osteoarcheological specimens. Two skeletons from the Bátmonostor cemetery (Hungary) demonstrate complete unilateral ankylosis of the knee. Macroscopic and radiographic examinations were undertaken to assess the extent of skeletal changes and determine their cause. Data obtained from computed tomography (CT) were constructed in 2D and 3D. The 2D CT images revealed cavities involving both the metaphyses and the epiphyses. The 3D reconstructions allowed us to reconstruct the more precise volumetric morphology of the circumscribed lytic lesions, as well as clear ‘image‐mirror’ lacunar volumes. On the basis of the macroscopic and radiological analyses, extra‐spinal tuberculous infection seems to have been the most probable etiology of these two cases. Copyright © 2012 John Wiley & Sons, Ltd.