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.     

Pelvic stress injuries in a small‐bodied forager

The assumption of natural selection for obstetric adequacy would predict the occasional discovery of skeletal evidence for inadequacy, yet such cases are rare. Here stress injuries to the pelvic ring are associated with an asymmetrical pelvis caused by partial agenesis of the right sacral costal process. The small, middle‐aged woman lived about 2000 years ago and pursued a physically vigorous life as a coastal forager on the South African Cape coast. The right sacral costal process (ala) is about 5 mm narrower than the left. This sacral hemiagenesis led to pelvic asymmetry, and concomitant instability. The six articular faces of the pelvis show the normal surfaces replaced by disorganised, porous new bone and extensive eburnation. The left pubic face shifted dorsally, making contact with the ventral aspect of the right pubis. The most distinctive aspect is the presence of osteitis pubis, or pubic symphysis stress injury, which is clinically associated both with difficult childbirth and with vigorous athletic activities. Adjustments to the altered pelvis include erosions and osteophytes at sites of ligament attachment, and prominent bilateral insertion areas on the tibiae for the stabilising iliotibial band. While habitual activities may explain some pelvic features, such as the bilateral bevelling of the acetabular borders, it is postulated that childbirth exacerbated the joint instability and the subsequent deterioration. This case joins a small literature on the condition of pubic symphysis stress injury, and illustrates the mechanisms through which natural selection for pelvic size and shape characteristics may have occurred. Copyright © 2010 John Wiley & Sons, Ltd.     

The pattern of spondylosis deformans in prehistoric samples from west‐central New Mexico

A Pre‐Columbian skeletal sample (n=42) from two ancestral Pueblo sites in the Rio Grande valley of west‐central New Mexico was examined for frequency and severity of spondylosis deformans (vertebral osteophytosis). No significant sex differences were detected. Degenerative changes in the collective sample are generally confined to no more than well‐defined horizontal lipping at the joint margins. Advanced proliferative osteophytic change is infrequent even in the oldest age category. Not surprisingly, the lumbar vertebrae were the most frequently and most severely involved vertebral segment for all three adult age cohorts defined. The cervical vertebrae were the least involved. This pattern generally conforms with observations made on other archaeological samples from west of the Mississippi River, but it contrasts with the general pattern of more extensive cervical involvement in Pre‐Columbian North American samples from the Eastern Woodlands. This possible east–west difference is hypothesized (Bridges, P.S. 1994. American Journal of Physical Anthropology 93: 83–93) to be related to differential burden bearing habits. Copyright © 2000 John Wiley & Sons, Ltd.     

CT and micro‐CT analysis of a case of Paget's disease (osteitis deformans) in the Grant skeletal collection

This paper presents a case study in which Paget's disease of bone is differentially diagnosed in an individual from the Grant skeletal collection using non‐destructive computed tomography (CT) and micro‐computed tomography (micro‐CT) analyses of the pubis, in addition to plain film radiography and macroscopic examination. In archaeological and modern osteological samples diagnosis frequently relies on macroscopic examination, plain film radiography and histological examination of bone samples. CT and micro‐CT modalities provide researchers with a non‐destructive view of the internal structure of bone unhampered by the superimposition that is characteristic of plain film radiographs. Given the importance of the increased cortical and trabecular thickness in the differential diagnosis of Paget's disease, these techniques are ideal means by which to non‐destructively examine culturally‐sensitive and scientifically‐valuable human remains for signs of Paget's disease of bone. Copyright © 2009 John Wiley & Sons, Ltd.