Joint fusions in palaeopathology: diagnosis and epidemiology

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Biological anthropology (humanbiology) is the science that focuses on the human being, man of the present and past may also be a challenging object. Human biology examines the biological characteristics of past populations. Its goal is to reconstruct the past societies on the basis of their biological characteristics, its analytical results let us to get more information about the life of ancient populations. Palaeopathology is a discipline of the biological anthropology; it focuses on the analyses of human remains. The examination of pathological skeletal alterations may help us to reconstruct special conditions like state of health, special environmental effects on a population or characteristics of the way of living in the past. The discipline can reveal such pathological conditions that were present in an archaeological period, it is able to analyse the prevalence and manifestation of a disease. Pathological processes may leave proliferative or lytic traces in the bones, fusions of the joints or their neighbouring area may also appear. These ankyloses may lead to partial or complete loss of capacity of movement in any joint; numerous aetiological factor may be responsible for the development of them. As the prevalence of ankyloses is quite low, we can usually meet them through case reports in the palaeopathological literature. Synthetic publications based on systematic analyses generally focus on only special diseases. Present study focuses on the analysis of the joint fusions’ nosological and epidemiological characteristics. Our primary aim following the data collection is to describe and analyze those potential macromorphological, radiological and histological signs or alterations, which may support our diagnostic effort and may provide one or more useful diagnostic criteria to recognize a disease in a more precise way. Ankyloses are relatively rarely observable alterations in osteoarchaeological series, thus we analyzed skeletal remains of numerous cemetery. Our examination material incorporated 29 series originating from the Great Hungarian Plain, the skeletal remains represent several archaeological periods. The oldest specimens are dated back the Sarmatian period (1st-5th c. AD), while the most present series are dated to the early modern times (18th c. AD). Summarizing the data, we can say that skeletal remains of 10.976 individuals have been included the examined material; our series are very diverse in their completeness and state of preservation. During the analysis basic anthropological data (sex, age at death, age categories) were available for us from previously carried out anthropological studies. Macromorphological examinations were made in the majority of the cases, but medical imaging techniques (X-ray, computed tomography) and histological methods were also utilized in certain cases. Results of previously carried out molecular biological analyses were available for us in some instances, these results helped to confirm our diagnosis. During our analyses single or multiple ankyloses were found in the skeletal remains of 346 individuals, they are associated with numerous nosological categories. Concerning the number of ankyloses, developmental diseases were found in the biggest number among our findings, the alterations were seen in all age categories. Their recognition was fairly easy, and the most typical predilectional areas are the spine and the thorax. The manifestation and distribution of the synostosis vertebralis and sacralization cases broadly correspond to the characteristics found in the literature. Fusions involving the sternal segments and functional ankyloses of the ribs are also seen, the recognition of the aetiology is not difficult in these cases, similarly to the developmental defects of the previous group. The distribution of the cases corresponds to the data seen in medical and palaeopathological references. Joint fusions associated with degenerative processes developed in the spine and the limbs. Concerning the axial localization, both the vertebral bodies and the posterior elements are involved. Common features of these fusions that irregular ankylosis line and fusion area characterized with irregular bony structure are recognizable. The cervical spine is involved the most; in the majority of cases signs of other degenerative processes (e.g. traces of spondylosis deformans and/or osteoarthritis) are also visible in the bony elements. An increasing tendency with ageing is recognizable, ankyloses of degenerative origin developed in more males than females...

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