1
|
Wissler A, DeWitte SN. Frailty and survival in the 1918 influenza pandemic. Proc Natl Acad Sci U S A 2023; 120:e2304545120. [PMID: 37812724 PMCID: PMC10589609 DOI: 10.1073/pnas.2304545120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/21/2023] [Indexed: 10/11/2023] Open
Abstract
One of the most well-known yet least understood aspects of the 1918 influenza pandemic is the disproportionately high mortality among young adults. Contemporary accounts further describe the victims as healthy young adults, which is contrary to the understanding of selective mortality, which posits that individuals with the highest frailty within a group are at the greatest risk of death. We use a bioarchaeological approach, combining individual-level information on health and stress gleaned from the skeletal remains of individuals who died in 1918 to determine whether healthy individuals were dying during the 1918 pandemic or whether underlying frailty contributed to an increased risk of mortality. Skeletal data on tibial periosteal new bone formation were obtained from 369 individuals from the Hamann-Todd documented osteological collection in Cleveland, Ohio. Skeletal data were analyzed alongside known age at death using Kaplan-Meier survival and Cox proportional hazards analysis. The results suggest that frail or unhealthy individuals were more likely to die during the pandemic than those who were not frail. During the flu, the estimated hazards for individuals with periosteal lesions that were active at the time of death were over two times higher compared to the control group. The results contradict prior assumptions about selective mortality during the 1918 influenza pandemic. Even among young adults, not everyone was equally likely to die-those with evidence of systemic stress suffered greater mortality. These findings provide time depth to our understanding of how variation in life experiences can impact morbidity and mortality even during a pandemic caused by a novel pathogen.
Collapse
Affiliation(s)
- Amanda Wissler
- Department of Anthropology, McMaster University, Hamilton, ONL8S 4M4, Canada
| | - Sharon N. DeWitte
- Institute of Behavioral Science, University of Colorado, Boulder, CO80309
- Department of Anthropology, University of Colorado, Boulder, CO80309
| |
Collapse
|
2
|
Rothschild BM, Jellema L, Lambert W. Demographics and significance of porotic hyperostosis as assessed by surface microscopy. Anat Rec (Hoboken) 2022; 305:2158-2165. [PMID: 35122474 DOI: 10.1002/ar.24881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/12/2021] [Accepted: 02/11/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Examination of parietal surface anatomy has been limited because standard techniques have insufficient resolution to identify and characterize the structures of interest. Perspectives derived thereof have not clarified their nature. Surface microscopy is pursued as a non-destructive technique to assess the character and implications of porotic pores (referred to as porotic hyperostosis), which have been subject of much speculation. METHODS The external surface of skulls, selected on the basis of age and gender, from the Hamann-Todd human collection are examined by epi-illumination microscopy for surface pores and to assess correlation with age, ethnicity, gender, anemia, infection, cancer, hypertrophic bone disorders, renal disease and fractures. RESULTS Pore-like surface defects are present in 2.7-5% of individuals in the third-fifth decades of life; 7%, in the sixth-eighth; and 25%, in the ninth-11th, but absent in the second decade of life. They are gender and birthdate-independent, but slightly more common in African Americans. Fractures are more common among individuals with parietal pores, while tuberculosis, cancer and hypertrophic bone diseases and anemia are less common. DISCUSSION This is the first study to actually examine the prevalence of parietal pores as a function of known age, race and sex and provides a baseline for comparison with populations in which those variables are not clearly identifiable. While some porotic pores may be related to marrow hyperplasia, trans-cortical circulation may explain the majority. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
| | - Lyman Jellema
- Cleveland Museum of Natural History, Wade Circle, Cleveland, OH, USA
| | | |
Collapse
|
3
|
van Spelde AM, Schroeder H, Kjellström A, Lidén K. Approaches to osteoporosis in paleopathology: How did methodology shape bone loss research? INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 33:245-257. [PMID: 34044198 DOI: 10.1016/j.ijpp.2021.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This paper will review how different methods employed to study bone loss in the past were used to explore different questions and aspects of bone loss, how methodology has changed over time, and how these different approaches have informed our understanding of bone loss in the past. MATERIALS AND METHODS A review and discussion is conducted on research protocols and results of 84 paleopathology publications on bone loss in archaeological skeletal collections published between 1969 and 2021. CONCLUSIONS The variety in research protocols confounds accurate meta-analysis of previously published research; however, more recent publications incorporate a combination of bone mass and bone quality based methods. Biased sample selection has resulted in a predominance of European and Medieval publications, limiting more general observations on bone loss in the past. Collection of dietary or paleopathological covariables is underemployed in the effort to interpret bone loss patterns. SIGNIFICANCE Paleopathology publications have demonstrated differences in bone loss between distinct archaeological populations, between sex and age groups, and have suggested factors underlying observed differences. However, a lack of a gold standard has encouraged the use of a wide range of methods. Understanding how this array of methods effects results is crucial in contextualizing our knowledge of bone loss in the past. LIMITATIONS The development of a research protocol is also influenced by available expertise, available equipment, restrictions imposed by the curator, and site-specific taphonomic aspects. These factors will likely continue to cause (minor) biases even if a best practice can be established. SUGGESTIONS FOR FUTURE RESEARCH Greater effort to develop uniform terminology and operational definitions of osteoporosis in skeletal remains, as well as the expansion of time scale and geographical areas studied. The Next-Generation Sequencing revolution has also opened up the possibility of ancient DNA analyses to study genetic predisposition to bone loss in the past.
Collapse
Affiliation(s)
- Anne-Marijn van Spelde
- Archaeological Research Laboratory, Department of Archaeology and Classical Studies, Stockholm University, Lilla Frescativägen 7, 114 18 Stockholm, Sweden; The Globe Institute, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Hannes Schroeder
- The Globe Institute, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark
| | - Anna Kjellström
- Osteological Research Laboratory, Department of Archaeology and Classical Studies, Stockholm University, Lilla Frescativägen 7, 114 18 Stockholm, Sweden
| | - Kerstin Lidén
- Archaeological Research Laboratory, Department of Archaeology and Classical Studies, Stockholm University, Lilla Frescativägen 7, 114 18 Stockholm, Sweden
| |
Collapse
|
4
|
Rothschild B. Comment on: Do rheumatoid arthritis patients have low back pain or radiological lumbar lesions more frequently than healthy population? Cross-sectional analysis in a cohort study with age and sex-matched healthy volunteers. Spine J 2021; 21:883-884. [PMID: 33966866 DOI: 10.1016/j.spinee.2021.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 02/03/2023]
|
5
|
Rothschild BM, Wayne Lambert H. Distinguishing between congenital phenomena and traumatic experiences: Osteochondrosis versus osteochondritis. J Orthop 2021; 23:185-190. [PMID: 33551611 DOI: 10.1016/j.jor.2021.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/15/2021] [Indexed: 11/18/2022] Open
Abstract
The current study is to distinguish between osteochondrosis and osteochondritis, utilizing surface microscopy of individuals with documented pathology. Osteochondrosis is associated with smooth borders and gradient from edge to defect base, while osteochondritis and subchondral impaction fractures are associated with subsidence of the affected area of articular surface with irregular edges. The base of osteochondrosis is penetrated by multiple channels, smoothly perforate its surface, indistinguishable from unfused epiphyses, confirming their vascular nature. This study provides a technique for distinguishing osteochondrosis and osteochondritis and further documents of the value of epi-illumination microscopy in expanding our understanding of bone and joint disease.
Collapse
Affiliation(s)
- Bruce M Rothschild
- IU Health, 2401 University Ave, Muncie, IN, 47303, USA
- Carnegie Museum of Natural History, 4400 Forbes Ave, Pittsburgh, PA, 15213, USA
| | - H Wayne Lambert
- Department of Pathology, Anatomy, and Laboratory Medicine (PALM), Division of Anatomy, West Virginia University School of Medicine, Robert C. Byrd Health Sciences Center, Morgantown, WV, 26506, USA
| |
Collapse
|
6
|
Rothschild B. The character of parietal and orbital alterations in the superfamily Hominoidea (families Hominidae [exclusive of Homo] and Hylobotidae). Am J Primatol 2020; 83:e23227. [PMID: 33347652 DOI: 10.1002/ajp.23227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 12/16/2022]
Abstract
Parietal external surface disruption routinely referred to as porotic hyperostosis, and orbital alterations (cribra orbitalia), have been attributed to anemia-related bone marrow hyperplasia in humans. A recent study in humans identified that they were actually vascular in nature. Skeletons were examined and epi-illumination surface microscopy was performed on the parietal region and orbit of 156 Hominidae and 123 Hylobotidae to assess if these phenomena were trans-phylogenetic. Trans-cortical channels were recognized on the basis of visualized ectocranial surface defects penetrating the parietal; cribra orbitalia, by alteration of the normally smooth orbital roof appearance. Trans-cortical parietal channels, ranging in size from 20 to 100 µm, are rare in Gorilla and Pan troglodytes and absent in Pan paniscus. They are universally present in adult Pongo abeli and in Hylobatidae, independent of species. Cribra orbitalia was common in Hylobotidae, Pongo pygmaeus and P. abelii, less prevalent in adult P. troglodytes, and not recognized in any Gorilla gorilla or P. paniscus examined. The proliferative form predominated, with the exception of Hylobates concolor and muelleri, in which uncalcified vascular grooves predominated. No correlation was observed between the presence of either trans-cortical channels or cribra orbitalia and fractures, osteoarthritis, or inflammatory arthritis. Parietal alterations observed in apes are trans-cortical channels, analogous to those observed in humans, and do not represent porosity. Similarly, cribra orbitalia in apes is confirmed as vascular in nature. The proliferative form apparently represents calcification of blood vessel walls, indistinguishable from observations in humans. Predominant presence in adults rather than in juveniles suggests that both forms are acquired rather than developmental in derivation. Sex and bone alteration/disease-independence suggests that mechanical, endocrine, and inflammatory phenomena do not contribute to the development of either. Further, independent occurrence of trans-cortical channels and cribra orbitalia suggests that they do not have a shared etiology.
Collapse
Affiliation(s)
- Bruce Rothschild
- Department of Vertebrate Paleontology, Carnegie Museum, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
7
|
Rothschild BM, Zdilla MJ, Jellema LM, Lambert HW. Cribra orbitalia is a vascular phenomenon unrelated to marrow hyperplasia or anemia: Paradigm shift for cribra orbitalia. Anat Rec (Hoboken) 2020; 304:1709-1716. [PMID: 33135369 DOI: 10.1002/ar.24561] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/12/2020] [Accepted: 10/20/2020] [Indexed: 02/03/2023]
Abstract
The orbital phenomenon, cribra orbitalia, has long been a source of controversy, especially with regard to its nature, derivation, and relationship to anemia. Therefore, the external surfaces of orbital roofs were systematically examined microscopically in human skulls from historical collections. Superior orbital surfaces of 278 individual crania within the Hamann-Todd collection were assessed at various magnifications using epi-illumination microscopy to identify the presence of cribra orbitalia and characterize its nature. Also, 12 additional individuals with diagnosed anemia in the Hamann-Todd collection were evaluated. Orbital roof alterations, present in one-third of examined crania, had two discrete appearances: Vascular grooves (45%) and application of new bone in a vascular branching pattern on the orbit surface (55%). Porosity of the orbit was not observed. Evaluation of the orbits of 12 individuals with diagnosed anemia revealed one with a single deep defect, suggesting a space-occupying phenomenon, but no evidence of bone accretion, vascular grooves, or porosity. Cribra orbitalia has often been lumped indiscriminately as an indicator of organismal stress, rather than identified as a indicating a specific etiology. Neither that perspective nor porosity are supported by high resolution examination of orbital roof changes. Recognition of the blood vessel imprint pattern falsifies previous speculations and provides a new paradigm. The actual character of cribra orbitalia is documented and new hypotheses generated. While population prevalence of cribra orbitalia seems excessive for explanation on the basis of these hypotheses, the imprints are clearly vascular in origin.
Collapse
Affiliation(s)
- Bruce M Rothschild
- Department of Vertebrate Paleontology, Carnegie Museum, Pittsburgh, Pennsylvania, USA
| | - Matthew J Zdilla
- Departments of Biology & Physician Assistant Studies, West Liberty University, West Liberty, West Virginia, USA.,Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University Anatomy Division, Morgantown, West Virginia, USA
| | - Lyman M Jellema
- Department of Physical Anthropology, Cleveland Museum of Natural History, Cleveland, Ohio, USA
| | - H Wayne Lambert
- Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University Anatomy Division, Morgantown, West Virginia, USA
| |
Collapse
|
8
|
Morgan B, Mant M, de la Cova C, Brickley MB. Osteoporosis, osteomalacia, and hip fracture: A case study from the Terry collection. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2020; 30:17-21. [PMID: 32402820 DOI: 10.1016/j.ijpp.2020.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/27/2020] [Accepted: 03/21/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This case study describes a perimortem hip fracture in a documented individual from the Robert J. Terry Skeletal Collection. The purpose of this paper is to comprehend how co-occurring conditions contributed to fracture risk and to understand the effect of the injury on this individual. MATERIALS AND METHODS A 73-year-old female from the Terry Collection with a fracture of the left proximal femur was assessed macroscopically, and images were taken with a Keyence VHX-2000 digital microscope. Documentation concerning the individual's history and contemporary treatment of hip fractures was explored. RESULTS Assessment demonstrated impaction of fractured elements occurred as a result of the inferior displacement of the femoral head into the femoral neck. Eburnation and hinge fractures are present on the fracture margins. Bending deformities of the sacrum, sternum, and ribs indicate underlying osteomalacia. No evidence of surgical intervention was observed. CONCLUSIONS Both osteomalacia and osteoporosis contributed to overall fracture risk in this case, which demonstrates how complex underlying factors can interact to increase the probability of fracture, and influence post-fracture mortality. SIGNIFICANCE This report is the first case study, to date, of a healing hip fracture in which the circumstances of the fracture and the medical history of the individual are known. LIMITATIONS To fully investigate osteoporosis, bone mineral density for this individual should be compared with others in the collection. SUGGESTIONS FOR FURTHER RESEARCH The effect of co-occurring conditions on fracture risk should be explored in the wider Terry Collection, and in other skeletal collections.
Collapse
Affiliation(s)
- Brianne Morgan
- Department of Anthropology, McMaster University, Hamilton, ON L8S 4L9, Canada.
| | - Madeleine Mant
- Department of Archaeology, Memorial University, St. John's, NL A1B 3R6, Canada; Department of Anthropology, University of Toronto Mississauga, Mississauga, ON L5L 1C6, Canada.
| | - Carlina de la Cova
- Department of Anthropology, University of South Carolina, Columbia, SC 29208, USA.
| | - Megan B Brickley
- Department of Anthropology, McMaster University, Hamilton, ON L8S 4L9, Canada.
| |
Collapse
|
9
|
Schmutz B, Schuetz F, Alkadhi H, Rühli F, Eppenberger P. Secular evolution of femoral morphology from a clinical perspective. Clin Anat 2020; 33:887-898. [PMID: 32115778 DOI: 10.1002/ca.23585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 02/08/2020] [Accepted: 02/19/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Intramedullary nailing is the surgical method of choice for the treatment of proximal femur or femoral shaft fractures. Implant manufacturers aim to design implants fitting for the broadest possible population segment. As complete morphological data sets of long bones are not widely available, anatomical collections of historical dry bone specimens may represent abundant additional sources of morphological three-dimensional (3D) data for implant design, provided they are consistent with present populations. This study aims to investigate secular trends and age-related changes of femoral morphology of the Caucasian population over the past 800 years. MATERIALS AND METHODS Computer graphical measurements of 3D-datasets of right and left femora derived from computed tomography (CT) scans, representative of the present Caucasian population, were compared to computer graphical measurements of 3D-datasets of right and left femora derived from CT scans of specimens from a historical medieval European bone collection. RESULTS Clinically relevant parameters of historical medieval European femora were found mostly consistent with correlative data of the present Caucasian population. Additionally, for some of the evaluated parameters, particularly anteversion, morphological differences significantly correlated to individual age and sex could be identified, whereas other parameters such as caput-collum-diaphyseal angle or radius of anterior femoral bowing were not correlated to individual age or sex. CONCLUSION The findings suggest that more recent historical specimen collections may be a convenient and easily accessible source of new 3D morphological data, as well as to complement existing data, to be used by researchers and manufacturers for the development of intramedullary femoral nails.
Collapse
Affiliation(s)
- Beat Schmutz
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Frederik Schuetz
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Hatem Alkadhi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Frank Rühli
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Patrick Eppenberger
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
10
|
Cardoso HFV, Spake L, Wasterlain SN, Ferreira MT. The impact of social experiences of physical and structural violence on the growth of African enslaved children recovered from Lagos, Portugal (15th-17th centuries). AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 168:209-221. [DOI: 10.1002/ajpa.23741] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/07/2018] [Accepted: 10/13/2018] [Indexed: 11/08/2022]
Affiliation(s)
- HFV Cardoso
- Department of Archaeology and Centre for Forensic Research; Simon Fraser University; Burnaby Canada
| | - L Spake
- Department of Archaeology and Centre for Forensic Research; Simon Fraser University; Burnaby Canada
| | - SN Wasterlain
- Centro de Investigação em Antropologia e Saúde, Department of Life Sciences; University of Coimbra; Coimbra Portugal
| | - MT Ferreira
- Laboratory of Forensic Anthropology, Centre for Functional Ecology, Department of Life Sciences; University of Coimbra; Coimbra Portugal
| |
Collapse
|
11
|
Ismail NA, Abd Khupur NH, Osman K, Mansar AH, Shafie MS, Mohd Nor F. Stature estimation in Malaysian population from radiographic measurements of upper limbs. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2018. [DOI: 10.1186/s41935-018-0055-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
12
|
Sharma A, Rieth GE, Tanenbaum JE, Williams JS, Ota N, Chakravarthi S, Manjila S, Kassam A, Yapicilar B. A morphometric survey of the parasellar region in more than 2700 skulls: emphasis on the middle clinoid process variants and implications in endoscopic and microsurgical approaches. J Neurosurg 2018; 129:60-70. [DOI: 10.3171/2017.2.jns162114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVEThe middle clinoid process (MCP) is a bony projection that extends from the sphenoid bone near the lateral margin of the sella turcica. The varied prevalence and morphological features of the MCP in populations stratified by age, race, and sex are unknown; however, the knowledge of its anatomy and preoperative recognition on CT scans can aid greatly in complication avoidance and management. The aim of this study was to further illustrate the surgical anatomy of the parasellar region and to quantify the incidence of MCP and caroticoclinoid rings (CCRs) in dried preserved human anatomical specimens.METHODSThe presence, dimensions, morphological classification (incomplete, contact, and CCR), and intracranial relations of the MCP were measured in 2726 dried skull specimens at the Hamann-Todd Osteological Collection at the Cleveland Museum of Natural History. Specific morphometric data points were recorded from each of these hemiskulls, and categorized based on age, sex, and ethnicity. Linear and logistic regressions were used to determine associations between explanatory variables and MCP morphology. Computed tomography scans of the skull specimens were obtained to explore radiological landmarks for different types of MCPs. Illustrative intraoperative videos were also analyzed in the light of these crucial surgical landmarks.RESULTSThe sample included 2250 specimens from males and 476 from females. Specimens were classified as either “white” (60.5%) or “black” (39.2%). An MCP was found in 42% of specimens, with 60% of those specimens presenting bilaterally. Fully ossified CCR comprised 27% of all MCPs, and contact (defined as contact without ossification between MCP and anterior clinoid process) comprised 4% of all MCPs. White race (relative to black race) and increasing age were significant predictors of MCP presence (p < 0.001). White race was significantly associated with greater average MCP height (p < 0.001). Among skulls with CCR, both male sex and older age (> 70 years relative to < 50 years) were associated with increased CCR diameter (p < 0.001). No other significant predictors or associations were observed. The CT scans of skulls replicated and validated the authors’ morphometric observations on incomplete, contact, and CCR patterns adequately. The surgical strategies of clinoid bone removal are validated, with appropriate video illustrations.CONCLUSIONSVariations in the patterns of bony MCPs can pose a significant risk for injury to the internal carotid artery during parasellar procedures, especially those involving clinoidectomy and optic strut drilling. Understanding parasellar anatomy, especially on skull-base CT imaging, may be integral to surgical planning and preoperative risk counseling in both transcranial and extended endonasal procedures, as well as to preparing for complications management perioperatively.
Collapse
Affiliation(s)
| | | | - Joseph E. Tanenbaum
- 1Case Western Reserve University School of Medicine
- 2Department of Epidemiology and Biostatistics, Case Western Reserve University; and
| | | | - Nakao Ota
- 4Department of Neurosurgery, Teishinkai Hospital, Sapporo, Hokkaido, Japan
| | | | - Sunil Manjila
- 6Department of Neurosciences, McLaren Bay Neurosurgery Associates, Bay City, Michigan
| | - Amin Kassam
- 5Aurora Neurosciences Center, Milwaukee, Wisconsin; and
| | - Bulent Yapicilar
- 1Case Western Reserve University School of Medicine
- 7Neurosurgery, MetroHealth Medical Center, Cleveland, Ohio
| |
Collapse
|
13
|
Age estimation of adult human remains from hip bones using advanced methods. Forensic Sci Int 2018; 287:163-175. [DOI: 10.1016/j.forsciint.2018.03.047] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/20/2018] [Accepted: 03/28/2018] [Indexed: 11/23/2022]
|
14
|
Differential diagnostic perspectives provided by en face microscopic examination of articular surface defects. Clin Rheumatol 2018; 37:831-836. [PMID: 29399706 DOI: 10.1007/s10067-018-4001-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 01/12/2018] [Accepted: 01/23/2018] [Indexed: 12/16/2022]
Abstract
Surface defects have a central position in diagnosis of articular pathology. Recognizing the limitations of standard radiologic techniques and those imposed by positioning and averaging artifacts on CT evaluation, direct visualization of surface defects was pursued to identify disease characteristics that would facilitate interpretation of radiologic findings. Epi-illumination surface microscopy was utilized to examine macroscopically recognized articular surface defects in individuals in the Hamann-Todd, Terry, and Huntington human skeletal collections with previously verified diagnoses of rheumatoid arthritis, spondyloarthropathy, juvenile inflammatory arthritis (JIA), calcium pyrophosphate deposition disease (CPPD), gout, metastatic cancer, multiple myeloma, septic arthritis, tuberculosis, fungal arthritis, histiocytosis and sickle cell anemia (Rothschild and Rothschild Clin Infect Dis 20(5):1402-1408, 1995; Rothschild et al. Amer J Phys Anthropol 82(4):441-449, 1990; Rothschild and Rothschild Amer J Phys Anthropol 96(4):357-563, 1995; Rothschild and Woods Clin Exp Rheumatol 10(2):117-122, 1992; Barrett and Keat Radiographics 24(6):1679-1691, 2004; Rothschild and Heathcote Amer J Phys Anthropol 98(4):519-525, 1995; Rothschild and Woods Am J Phys Anthropol 85:25-34, 1991; Hershkovitz et al. Amer J Phys Anthropol 106(1):47-60, 1998; Winland et al. Amer J Phys Anthropol 24:S243, 1997; Rothschild et al. Clin Exp Rheumatol 10(6):557-564, 1992; Rothschild and Martin , 2006; Rothschild et al. Amer J Phys Anthropol 102(2):249-264, 1997). Observed alterations were compared with standard radiographs. Fronts of resorption distinguished inflammatory arthritis from those caused by the other disorders studied. Multiple myeloma, fungal disease, and gout are expansile character; the latter accompanied by reactive new bone formation more prominent than that noted with spondyloarthropathy and JIA. Those were clearly distinguished from the crumbling alterations found with CPPD. Histiocytosis had a unique crenulated appearance, while nodules were prominent with syphilis. Defects in sickle cell anemia had ivory fragments at their base. These findings provided explanation for radiologic observations. Direct surface microscopy revealed characteristics apparently pathognomonic for specific disorders and facilitated distinguishing among them. The technique provides visualization an order of magnitude greater than that available with clinical radiologic techniques and identifies new characteristics which should facilitate clinical diagnoses. This demonstrates that there would be value to the development of higher resolution, clinically applicable imaging techniques.
Collapse
|
15
|
Nature of Perceived Bone Defects in Apparently Otherwise Healthy Individuals: Source of the Erosive Perspective. J Clin Rheumatol 2017; 24:437-439. [PMID: 29280827 DOI: 10.1097/rhu.0000000000000664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
16
|
Rothschild B. Correlation of Periodontal Disease With Inflammatory Arthritis in the Time Before Modern Medical Intervention. J Periodontol 2016; 88:266-272. [PMID: 27834119 DOI: 10.1902/jop.2016.160422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Controversy exists regarding possible correlation of periodontal disease with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Confounding factors may relate to stringency of inflammatory disease diagnosis and the effect of therapeutic intervention for RA on periodontal disease. These factors are investigated in this study. METHODS Forty-five individuals with documented RA (n = 15), spondyloarthropathy (n = 15), and calcium pyrophosphate deposition disease (CPPD) (n = 15), from the Hamann-Todd collection of human skeletons compiled from 1912 to 1938, and 15 individuals contemporarily incorporated in the collection were examined for tooth loss, cavity occurrence, average and maximum lingual and buccal depth of space between tooth and bone, periosteal reaction, serpentine bone resorption, abscess formation, and root penetration of the bone surface and analyzed by analysis of variance. RESULTS Tooth loss was common, but actual number of teeth lost, cavity occurrence, average and maximum lingual and buccal depth of space between tooth and bone, periosteal reaction, serpentine grooving surrounding teeth (considered a sign of inflammation), abscess formation, and root exposure (penetration of bone surface) were indistinguishable among controls and individuals with RA, spondyloarthropathy, and CPPD. CONCLUSIONS Although many factors can affect periodontal disease, presence of inflammatory arthritis does not appear to be one of them. The implication is that dental disease was common in the general population and not necessarily associated with arthritis, at least before the advent of modern rheumatologic medications. As specific diagnosis did not affect prevalence, perhaps current prevalence controversy may relate to current intervention, a subject for further study.
Collapse
Affiliation(s)
- Bruce Rothschild
- Northeast Ohio Medical University, Rootstown, OH.,Vertebrate Paleontology, Carnegie Museum of Natural History, Pittsburgh, PA
| |
Collapse
|
17
|
Chilakamary VK, Lakkireddy M, Koppolu KK, Rapur S. Osteosynthesis in Distal Radius Fractures with Conventional Bridging External Fixator; Tips and Tricks for Getting Them Right. J Clin Diagn Res 2016; 10:RC05-8. [PMID: 26894133 DOI: 10.7860/jcdr/2016/16696.7048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 11/25/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Distal radius fractures are the commonest fractures occurring in the upper extremity, accounting for 15-20% of patients treated in emergency department. Although distal radial fractures were described 200 years ago, they still remain as unsolved fractures with no clear guidelines. It is often reported that anatomical reduction has a bearing on the functional outcome. AIM To study the management of distal end radius fracture by utilizing the principle of ligamentotaxis where in the reduction obtained by closed means is maintained by external fixator till solid bony union occurs. MATERIALS AND METHODS A total of 26 cases were selected for study by scrutiny of the inclusion and exclusion criteria. Most of our cases were treated with external fixator within 8 hrs of injury. Small A.O external fixator (bridging ex-fix) with 2 pins each in radius and 2(nd) metacarpal percutaneously was used for all the cases. Selective k wire fixation was done in cases of instability. Fixator was removed after 6 weeks. Guided physiotherapy was ensured in all the cases. Patients were followed up for an average of 9 months. RESULTS Modified Gartland and Werley scoring system was used to evaluate the overall functional results. Excellent to good results were achieved in 88.45% of our cases while fair result was in 11.54 %. One case had pin loosening and two other cases had malunion. CONCLUSION External fixator used for ligamentotaxis is an effective method of treating unstable extraarticular and complex intraarticular fractures of distal radius. Improved anatomical restoration with early rehabilitation has produced favourable functional outcome in our series. The complications like pin tract infection is rare due to the availability of superior antibiotics and sterile surgical technique. complications like wrist and finger stiffness has improved with physiotherapy.
Collapse
Affiliation(s)
- Vamshi Krishna Chilakamary
- Assistant professor, Department of Orthopaedics, Kamineni Institute of Medical Sciences , Narketpally, Nalgonda, India
| | - Maheshwar Lakkireddy
- Assistant Professor, Department of Orthopaedics, Nizam's Institute of Medical Sciences , Hyderabad, India
| | - Kiran Kumar Koppolu
- Assistant Professor, Department of Orthopaedics, Nizam's Institute of Medical Sciences , Hyderabad, India
| | - Shivaprasad Rapur
- Professor and HOD, Department of Orthopaedics, Mediciti Institute of Medical Sciences , Hyderabad, India
| |
Collapse
|
18
|
Rusk K, Ousley SD. An evaluation of sex- and ancestry-specific variation in sacral size and shape using geometric morphometrics. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2015; 159:646-54. [DOI: 10.1002/ajpa.22926] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/25/2015] [Accepted: 12/03/2015] [Indexed: 11/09/2022]
Affiliation(s)
- K.M. Rusk
- KM Rusk, University of New Mexico; Albuquerque New Mexico 87131
| | | |
Collapse
|
19
|
Bekic M, Mikolaucic M, Golubovic M, Kojic N, Lenz R, Lojpur J, Bekic M. A three-year follow-up on injuries sustained by cruise ship passengers and crew treated at the Orthopaedic and Traumatology Department at Dubrovnik County Hospital. Injury 2015; 46 Suppl 6:S73-7. [PMID: 26612476 DOI: 10.1016/j.injury.2015.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Dubrovnik is one of the most popular destinations in the world for cruise ships. Several cruise ship passengers and crew members who have suffered different injuries have been treated at our department. This was a retrospective study to analyse injuries that occurred to crew members and passengers on cruise ships that docked in Dubrovnik over a three-year period from December 2010 to December 2013. During this period, a total of 370 patients suffered trauma that needed medical treatment. A total of 119 of these patients required hospitalisation and received medical help based on the nature of the trauma they suffered. The remaining 251 patients were treated at our outpatient clinic. Female patients in this study were exposed to osteoporotic trauma. Male patients presented mostly with injuries sustained during physical activities or because of the nature of their job on board. The leading cause of trauma accidents in the present study was falls on the same level.
Collapse
Affiliation(s)
- Marijo Bekic
- Orthopaedic and Traumatology Department, Dubrovnik County Hospital, Dubrovnik, Croatia.
| | - Michele Mikolaucic
- Orthopaedic and Traumatology Department, Dubrovnik County Hospital, Dubrovnik, Croatia
| | - Marko Golubovic
- Orthopaedic and Traumatology Department, Dubrovnik County Hospital, Dubrovnik, Croatia
| | | | | | - Jakisa Lojpur
- Orthopaedic and Traumatology Department, Dubrovnik County Hospital, Dubrovnik, Croatia
| | | |
Collapse
|
20
|
Sarig R, Hershkovitz I, Shpack N, May H, Vardimon AD. Rate and pattern of interproximal dental attrition. Eur J Oral Sci 2015; 123:276-81. [DOI: 10.1111/eos.12198] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Rachel Sarig
- Department of Orthodontics; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
- Dan David Center for Human Evolution and Biohistory; The Steinhardt Museum of Natural History and National Research Center; Tel Aviv University; Tel Aviv Israel
| | - Israel Hershkovitz
- Dan David Center for Human Evolution and Biohistory; The Steinhardt Museum of Natural History and National Research Center; Tel Aviv University; Tel Aviv Israel
- Department of Anatomy and Anthropology; The Sackler Faculty of Medicine; Tel-Aviv University; Tel Aviv Israel
| | - Nir Shpack
- Department of Orthodontics; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - Hila May
- Dan David Center for Human Evolution and Biohistory; The Steinhardt Museum of Natural History and National Research Center; Tel Aviv University; Tel Aviv Israel
- Department of Anatomy and Anthropology; The Sackler Faculty of Medicine; Tel-Aviv University; Tel Aviv Israel
| | - Alexander D. Vardimon
- Department of Orthodontics; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| |
Collapse
|
21
|
Abstract
UNLABELLED Small variations within normal range of radiographic parameters, except ulnar variance and volar tilt, do not influence the final functional outcome in distal radius fractures. INTRODUCTION There are many reports in the literature on the relationship between radiographic variables and their influence on the final outcome of distal radius fractures. Most authors report that a good functional result depends on anatomical restoration of the articular surface and extra-articular alignment. The aim of this study was to verify if it is really necessary to restore anatomic radiographic parameters to obtain satisfactory functional outcome in distal radius fractures treated with volar plate. MATERIALS AND METHODS We retrospectively evaluated 51 patients treated with volar locked plate for articular unstable distal radius fractures from December 2006 to March 2009. Each fracture was evaluated according to the AO classification. The average follow-up was 40.5 months. Radiological measurements were performed considering radial height, radial inclination, volar tilt and ulnar variance, both preoperatively and postoperatively, to estimate the correction value. We examined range of motion (ROM), grip strength with a Jamar(®) dynamometer and Disabilities of the Arm, Shoulder and Hand (DASH) score. The τ Student test was performed for statistical analysis. RESULTS The persistence of articular step-off was assessed in 35.3% of patients. Normal radial inclination (21-25°) was restored in 74.5% of patients (range 15-27.5°). Normal radial height (10-13 mm) was restored in 66.6% of patients (range 6.8-17.3mm). Normal volar tilt (7-15°) was achieved in 90.2% of patients (range 3-17°). Normal ulnar variance (0.7-1.5mm) was restored in 86.3% of patients (range 0.7-4.1mm). There was a statistically significant difference between the preoperative and postoperative radiographic values (p<0.01). The majority of patients showed complete recovery of ROM, with no statistically significant difference (p>0.05) in extension, flexion, supination and pronation compared with the contralateral hand. Eight patients who had postoperative volar tilt and/or ulnar variance out of range had a statistically significant difference (p<0.05) in ROM compared with the non-operated side. At final follow-up, all patients had a statistically significant difference (p<0.05) in grip strength compared with the contralateral side, even with good strength values. The mean DASH score was 12.2 (range 0-61). DISCUSSION AND CONCLUSION Our experience suggests that ulnar variance and volar tilt are the most important radiographic parameters to be restored to obtain good functional outcome in distal radius fracture. Small variations of other radiographic parameters seem to not affect the final outcome at minimum 3 years' follow-up.
Collapse
|
22
|
Falys CG, Prangle D. Estimating age of mature adults from the degeneration of the sternal end of the clavicle. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2014; 156:203-14. [PMID: 25327699 PMCID: PMC4303940 DOI: 10.1002/ajpa.22639] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 10/05/2014] [Accepted: 10/06/2014] [Indexed: 11/12/2022]
Abstract
The sternal end of the clavicle has been illustrated to be useful in aging young adults, however, no studies have investigated what age-related changes occur to the sternal end post epiphyseal fusion. In this study, three morphological features (i.e., surface topography, porosity, and osteophyte formation) were examined and scored using 564 clavicles of individuals of European ancestry (n = 318 males; n = 246 females), with known ages of 40+ years, from four documented skeletal collections: Hamann-Todd, Pretoria, St. Bride's, and Coimbra. An ordinal scoring method was developed for each of the three traits. Surface topography showed the strongest correlation with age, and composite scores (formed by summing the three separate trait scores) indicated progressive degeneration of the surface with increasing chronological age. Linear regression analyses were performed on the trait scores to produce pooled-sample age estimation equations. Blind tests of the composite score method and regression formulae on 56 individuals, aged 40+ years, from Christ Church Spitalfields, suggest accuracies of 96.4% for both methods. These preliminary results display the first evidence of the utility of the sternal end of the clavicle in aging older adult individuals. However, in the current format, these criteria should only be applied to individuals already identified as over 40 years in order to refine the age ranges used for advanced age. These findings do suggest the sternal end of the clavicle has potential to aid age estimates beyond the traditional "mature adult" age category (i.e., 46+ years), and provides several suggestions for future research.
Collapse
Affiliation(s)
- Ceri G Falys
- Department of Archaeology, School of Archaeology, Geography and Environmental Science, University of Reading, Reading, Berkshire, RG6 6AB, UK
| | | |
Collapse
|
23
|
Schlecht SH, Bigelow EMR, Jepsen KJ. Mapping the natural variation in whole bone stiffness and strength across skeletal sites. Bone 2014; 67:15-22. [PMID: 24999223 PMCID: PMC4786740 DOI: 10.1016/j.bone.2014.06.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 06/20/2014] [Accepted: 06/25/2014] [Indexed: 10/25/2022]
Abstract
Traits of the skeletal system are coordinately adjusted to establish mechanical homeostasis in response to genetic and environmental factors. Prior work demonstrated that this 'complex adaptive' process is not perfect, revealing a two-fold difference in whole bone stiffness of the tibia across a population. Robustness (specifically, total cross-sectional area relative to length) varies widely across skeletal sites and between sexes. However, it is unknown whether the natural variation in whole bone stiffness and strength also varies across skeletal sites and between men and women. We tested the hypotheses that: 1) all major long bones of the appendicular skeleton demonstrate inherent, systemic constraints in the degree to which morphological and compositional traits can be adjusted for a given robustness; and 2) these traits covary in a predictable manner independent of body size and robustness. We assessed the functional relationships among robustness, cortical area (Ct.Ar), cortical tissue mineral density (Ct.TMD), and bone strength index (BSI) across the long bones of the upper and lower limbs of 115 adult men and women. All bones showed a significant (p<0.001) positive regression between BSI and robustness after adjusting for body size, with slender bones being 1.7-2.3 times less stiff and strong in men and 1.3-2.8 times less stiff and strong in women compared to robust bones. Our findings are the first to document the natural inter-individual variation in whole bone stiffness and strength that exist within populations and that is predictable based on skeletal robustness for all major long bones. Documenting and further understanding this natural variation in strength may be critical for differentially diagnosing and treating skeletal fragility.
Collapse
Affiliation(s)
- Stephen H Schlecht
- Department of Orthopaedic Surgery, University of Michigan, Biomedical Sciences Research Building, Ann Arbor, MI 48109, USA.
| | - Erin M R Bigelow
- Department of Orthopaedic Surgery, University of Michigan, Biomedical Sciences Research Building, Ann Arbor, MI 48109, USA
| | - Karl J Jepsen
- Department of Orthopaedic Surgery, University of Michigan, Biomedical Sciences Research Building, Ann Arbor, MI 48109, USA
| |
Collapse
|
24
|
Sarig R, Hershkovitz I, Shvalb N, Sella-Tunis T, May H, Vardimon AD. Proximal attrition facets: morphometric, demographic, and aging characteristics. Eur J Oral Sci 2014; 122:271-8. [DOI: 10.1111/eos.12135] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2014] [Indexed: 12/24/2022]
Affiliation(s)
- Rachel Sarig
- Department of Orthodontics; Faculty of Medicine; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
- Department of Anatomy and Anthropology; Faculty of Medicine; The Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Israel Hershkovitz
- Department of Anatomy and Anthropology; Faculty of Medicine; The Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Nir Shvalb
- Department of Mechanical Engineering; Ariel University; Ariel Israel
| | - Tatiana Sella-Tunis
- Department of Orthodontics; Faculty of Medicine; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
- Department of Anatomy and Anthropology; Faculty of Medicine; The Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Hila May
- Department of Anatomy and Anthropology; Faculty of Medicine; The Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Alexander D. Vardimon
- Department of Orthodontics; Faculty of Medicine; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| |
Collapse
|
25
|
Franks EM, Cabo LL. Quantifying asymmetry: Ratios and alternatives. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2014; 154:498-511. [DOI: 10.1002/ajpa.22539] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 05/06/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Erin M. Franks
- Department of Biological Sciences; The University of Notre Dame; Notre Dame IN 46556
| | - Luis L. Cabo
- Department of Applied Forensic Sciences; Mercyhurst University; Erie PA 16546
| |
Collapse
|
26
|
Schlecht SH, Jepsen KJ. Functional integration of skeletal traits: an intraskeletal assessment of bone size, mineralization, and volume covariance. Bone 2013; 56:127-38. [PMID: 23721816 PMCID: PMC7368883 DOI: 10.1016/j.bone.2013.05.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 05/08/2013] [Accepted: 05/10/2013] [Indexed: 11/24/2022]
Abstract
Understanding the functional integration of skeletal traits and how they naturally vary within and across populations will benefit assessments of functional adaptation directed towards interpreting bone stiffness in contemporary and past humans. Moreover, investigating how these traits intraskeletally vary will guide us closer towards predicting fragility from a single skeletal site. Using an osteological collection of 115 young adult male and female African-Americans, we assessed the functional relationship between bone robustness (i.e. total area/length), cortical tissue mineral density (Ct.TMD), and cortical area (Ct.Ar) for the upper and lower limbs. All long bones demonstrated significant trait covariance (p < 0.005) independent of body size, with slender bones having 25-50% less Ct.Ar and 5-8% higher Ct.TMD compared to robust bones. Robustness statistically explained 10.2-28% of Ct.TMD and 26.6-64.6% of Ct.Ar within male and female skeletal elements. This covariance is systemic throughout the skeleton, with either the slender or robust phenotype consistently represented within all long bones for each individual. These findings suggest that each person attains a unique trait set by adulthood that is both predictable by robustness and partially independent of environmental influences. The variation in these functionally integrated traits allows for the maximization of tissue stiffness and minimization of mass so that regardless of which phenotype is present, a given bone is reasonably stiff and strong, and sufficiently adapted to perform routine, habitual loading activities. Covariation intrinsic to functional adaptation suggests that whole bone stiffness depends upon particular sets of traits acquired during growth, presumably through differing levels of cellular activity, resulting in differing tissue morphology and composition. The outcomes of this intraskeletal examination of robustness and its correlates may have significant value in our progression towards improved clinical assessments of bone strength and fragility.
Collapse
Affiliation(s)
- Stephen H Schlecht
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
| | | |
Collapse
|
27
|
Pablos A, Gómez-Olivencia A, García-Pérez A, Martínez I, Lorenzo C, Arsuaga JL. From toe to head: Use of robust regression methods in stature estimation based on foot remains. Forensic Sci Int 2013; 226:299.e1-7. [DOI: 10.1016/j.forsciint.2013.01.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 11/01/2012] [Accepted: 01/07/2013] [Indexed: 11/15/2022]
|
28
|
The age at death assessment in a multi-ethnic sample of pelvic bones using nature-inspired data mining methods. Forensic Sci Int 2012; 220:294.e1-9. [DOI: 10.1016/j.forsciint.2012.02.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 01/10/2012] [Accepted: 02/26/2012] [Indexed: 11/21/2022]
|
29
|
Martins R, Oliveira PE, Schmitt A. Estimation of age at death from the pubic symphysis and the auricular surface of the ilium using a smoothing procedure. Forensic Sci Int 2011; 219:287.e1-7. [PMID: 22206714 DOI: 10.1016/j.forsciint.2011.11.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 04/27/2011] [Accepted: 11/30/2011] [Indexed: 11/25/2022]
Abstract
We discuss here the estimation of age at death from two indicators (pubic symphysis and the sacro-pelvic surface of the ilium) based on four different osteological series from Portugal, Great-Britain, South Africa or USA (European origin). These samples and the scoring system of the two indicators were used by Schmitt et al. (2002), applying the methodology proposed by Lucy et al. (1996). In the present work, the same data was processed using a modification of the empirical method proposed by Lucy et al. (2002). The various probability distributions are estimated from training data by using kernel density procedures and Jackknife methodology. Bayes's theorem is then used to produce the posterior distribution from which point and interval estimates may be made. This statistical approach reduces the bias of the estimates to less than 70% of what was obtained by the initial method. This reduction going up to 52% if knowledge of sex of the individual is available, and produces an age for all the individuals that improves age at death assessment.
Collapse
Affiliation(s)
- Rui Martins
- Centro de Investigação Interdisciplinar Egas Moniz (ciiEM), Escola Superior de Saúde Egas Moniz (ESSEM), Quinta da Granja, Monte de Caparica, Caparica, Portugal.
| | | | | |
Collapse
|
30
|
Husmann PR, Samson DR. In the eye of the beholder: sex and race estimation using the human orbital aperture. J Forensic Sci 2011; 56:1424-9. [PMID: 21827460 DOI: 10.1111/j.1556-4029.2011.01864.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
From the works of Broca and Krogman to modern-day Jantz and Buikstra, the orbit has been used for both quantitative and qualitative sex and race estimation. This study evaluates the practical value of these estimations. Orbital height and breadth were measured to determine the orbital index and assess differences between men and women or black people and white people in the Hamann-Todd Collection. Replicability of these measures was also examined. Finally, a geometric morphometric study was performed to assess shape differences using the entire margin. Significant differences were found in both the index and the geomorphometric study; however, further investigation revealed that the differences were of little practical use. The measurement differences were found to be smaller than intra-observer error, while the geometric morphometric analysis demonstrated that minimal percentage of variation in shape was attributable to group differences. Thus, these techniques should not be used to estimate sex or race.
Collapse
Affiliation(s)
- Polly R Husmann
- Indiana University, Student Building 130, Bloomington, IN 47405, USA
| | | |
Collapse
|
31
|
CURATE FRANCISCO, ASSIS SANDRA, LOPES CÉLIA, SILVA ANAMARIA. Hip fractures in the Portuguese archaeological record. ANTHROPOL SCI 2011. [DOI: 10.1537/ase.100211] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- FRANCISCO CURATE
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra
| | - SANDRA ASSIS
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra
| | - CÉLIA LOPES
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra
| | - ANA MARIA SILVA
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra
| |
Collapse
|
32
|
Krebs V, Incavo SJ, Shields WH. The anatomy of the acetabulum: what is normal? Clin Orthop Relat Res 2009; 467:868-75. [PMID: 18648904 PMCID: PMC2650057 DOI: 10.1007/s11999-008-0317-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Accepted: 05/07/2008] [Indexed: 01/31/2023]
Abstract
Published studies of the human hip make frequent reference to the normal pelvis and acetabulum. However, other than qualitative descriptions we found no clinically applicable published references describing a normal pelvis and acetabulum; such information is important for designing certain kinds of implants (eg, reconstruction cages). We describe a method to quantify, average, and apply data gathered from normal human specimens to create a standard representation of the ilium and ischium. One hundred healthy hemipelves from 50 human skeletons were evaluated. We measured angles and distances between major anatomic landmarks in the pelvis. The data collected were analyzed for variance and averaged to create a normal topographic map. Finally, we examined several commercially available acetabular reconstruction cages to determine the fit to the anatomically determined normal pelvis. These results provide a representation of true acetabular geometry and may serve as the basis for future acetabular reconstruction cage design.
Collapse
Affiliation(s)
- Viktor Krebs
- Division of Reconstructive Surgery, Cleveland Clinic, Cleveland, OH USA
| | - Stephen J. Incavo
- Weill Cornell Medical College of Cornell University, New York, NY USA ,Adult Reconstructive Surgery, The Methodist Hospital, 6550 Fannin, 25th Floor, Houston, TX 77030 USA
| | | |
Collapse
|
33
|
Kunos CA, Dobbins DC, Kulasekere R, Latimer B, Kinsella TJ. Comparison of Helical Tomotherapy versus Conventional Radiation to Deliver Craniospinal Radiation. Technol Cancer Res Treat 2008; 7:227-33. [DOI: 10.1177/153303460800700308] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to investigate whether helical tomotherapy would better dose-limit growing vertebral ring apophyses during craniospinal radiation as compared to conventional techniques. Four pediatric patients with M0 medulloblastoma received tomotherapy craniospinal radiation (23.4 Gy, 1.8 Gy/fx) by continuous helical delivery of 6 MV photons. Weekly blood counts were monitored. For comparison, conventional craniospinal radiation plans were generated. To assist in tomotherapy planning, a cross-sectional growth study of 52 children and young adults was completed to evaluate spine growth and maturation. Vertebral ring apophyses first fused along the posterolateral body-pedicle synostosis, proceeding circumferentially toward the anterior vertebral body such that the cervical and lumbar vertebrae fused early and mid-thoracic vertebrae fused late. For the four pediatric patients, tomotherapy resulted between 2% and 14% vertebral volume exceeding 23 Gy. Conventional craniospinal radiation predicted between 33% and 44% exceeding 23 Gy. Cumulative body radiation doses exceeding 4 Gy were between 50% and 57% for tomotherapy and between 25% and 37% for conventional craniospinal radiation. Tomotherapy radiation reduced neutrophil, platelet, and erythrocyte hemoglobin levels during treatment. Tomotherapy provides improved dose avoidance to growing vertebrae as compared to conventional craniospinal radiation. However, the long-term effects of tomotherapy dose avoidance on spine growth and large volume low dose radiation in children are not yet known.
Collapse
Affiliation(s)
- Charles A. Kunos
- Department of Radiation Oncology CASE Comprehensive Cancer Center and Case Western Reserve University 11100 Euclid Avenue Cleveland, Ohio 44106-6068, USA
- Laboratory of Physical Anthropology The Cleveland Museum of Natural History 1 Wade Oval Cleveland, Ohio 44106, USA
| | - Donald C. Dobbins
- Department of Radiation Oncology CASE Comprehensive Cancer Center and Case Western Reserve University 11100 Euclid Avenue Cleveland, Ohio 44106-6068, USA
| | - Ravi Kulasekere
- Department of Radiation Oncology CASE Comprehensive Cancer Center and Case Western Reserve University 11100 Euclid Avenue Cleveland, Ohio 44106-6068, USA
| | - Bruce Latimer
- Laboratory of Physical Anthropology The Cleveland Museum of Natural History 1 Wade Oval Cleveland, Ohio 44106, USA
| | | |
Collapse
|
34
|
|
35
|
Rothschild BM, Behnam S. The often overlooked digital tuft: clues to diagnosis and pathophysiology of neuropathic disease and spondyloarthropathy. Ann Rheum Dis 2005; 64:286-90. [PMID: 15647437 PMCID: PMC1755351 DOI: 10.1136/ard.2004.021303] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess diagnostic implications of abnormalities of the pedal digital tufts and to identify features to facilitate distinguishing of spondyloarthropathy and leprosy. BACKGROUND Better criteria for distinguishing between these disorders are necessary if their character, natural history, and evolution are to be understood. METHODS Pedal x rays of 91 consecutive patients with diabetes, 21 alcoholic patients, 100 with spondyloarthropathy, 8 with scleroderma, and 137 with leprosy, and 188 defleshed skeletons of individuals with alcoholism, syphilis, cerebrovascular disease, and paraplegia from the Terry and Hamman-Todd collections were examined for evidence of osseous and articular pathologies. Digital tuft abnormalities were divided into irregularity, divot, flattening, resorption, whittling, and fragmentation. RESULTS Tuft divots were more common in alcoholics than in diabetic, and were more common in both than in the other groups studied. Tuft flattening was limited to alcoholic and neurosyphilis groups. Tuft whittling was especially prominent among individuals with spondyloarthropathy, contrasted with leprosy and diabetes. Aligned fractures were more common in diabetics than individuals with leprosy. Misaligned fractures were limited to individuals with leprosy and neurosyphilis. Leprosy and spondyloarthropathy were complicated by phalangeal and metatarsal whittling more commonly than other diseases studied. Background pedal abnormalities, derived from individuals with cardiovascular syphilis, cerebrovascular accidents, and paraplegia, was limited to abnormal divots only. CONCLUSIONS Pedal digital tufts undergo a variety of pathological alterations useful in the recognition of disorders traditionally considered neuropathic in aetiology and in distinguishing differential considerations. Tuft flattening appears specific for alcoholism and neurosyphilis, and misaligned fractures seem specific for neurosyphilis and leprosy, providing differential assistance related to spondyloarthropathy. Conversely, periosteal reaction distinguishes spondyloarthropathy from leprosy.
Collapse
Affiliation(s)
- B M Rothschild
- Arthritis Center of Northeast Ohio, 5500 Market, Youngstown, OH 44512, USA.
| | | |
Collapse
|
36
|
Variability of the Pattern of Aging on the Human Skeleton: Evidence from Bone Indicators and Implications on Age at Death Estimation. J Forensic Sci 2002. [DOI: 10.1520/jfs15551j] [Citation(s) in RCA: 100] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
37
|
Lovejoy CO, Meindl RS, Ohman JC, Heiple KG, White TD. The Maka femur and its bearing on the antiquity of human walking: applying contemporary concepts of morphogenesis to the human fossil record. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2002; 119:97-133. [PMID: 12237933 DOI: 10.1002/ajpa.10111] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
MAK-VP-1/1, a proximal femur recovered from the Maka Sands (ca. 3.4 mya) of the Middle Awash, Ethiopia, and attributed to Australopithecus afarensis, is described in detail. It represents the oldest skeletal evidence of locomotion in this species, and is analyzed from a morphogenetic perspective. X-ray, CT, and metric data are evaluated, using a variety of methods including discriminant function. The specimen indicates that the hip joint of A. afarensis was remarkably like that of modern humans, and that the dramatic muscle allocation shifts which distinguish living humans and African apes were already present in a highly derived form in this species. Its anatomy provides no indication of any form of locomotion save habitual terrestrial bipedality, which very probably differed only trivially from that of modern humans.
Collapse
Affiliation(s)
- C Owen Lovejoy
- Department of Anthropology, Kent State University, Ohio 44242, USA.
| | | | | | | | | |
Collapse
|
38
|
Cerroni AM, Tomlinson GA, Turnquist JE, Grynpas MD. Bone mineral density, osteopenia, and osteoporosis in the rhesus macaques of Cayo Santiago. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2000; 113:389-410. [PMID: 11042540 DOI: 10.1002/1096-8644(200011)113:3<389::aid-ajpa9>3.0.co;2-i] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This cross-sectional study investigates metabolic bone disease and the relationship between age and bone mineral density (BMD) in males and females of a large, well-documented skeletal population of free-ranging rhesus monkeys (Macaca mulatta), from the Caribbean Primate Research Center Museum collection from Cayo Santiago, Puerto Rico. The sample consists of 254 individuals aged 1.0-20+ years. The data consist of measurements of bone mineral content and bone mineral density, obtained from dual-energy X-ray absorptiometry (DEXA), of the last lumbar vertebra from each monkey. The pattern of BMD differs between male and female rhesus macaques. Females exhibit an initial increase in BMD with age, with peak bone density occurring around age 9.5 years, and remaining constant until 17.2 years, after which there is a steady decline in BMD. Males acquire bone mass at a faster rate, and attain a higher peak BMD at an earlier age than do females, at around 7 years of age, and BMD remains relatively constant between ages 7-18.5 years. After age 7 there is no apparent effect of age on BMD in the males of this sample; males older than 18.5 years were excluded due to the presence of vertebral osteophytosis, which interferes with DEXA. The combined frequency of osteopenia and osteoporosis in this population is 12.4%. BMD values of monkeys with vertebral wedge fractures are generally higher than those of virtually all of the nonfractured osteopenic/osteoporotic individuals, thus supporting the view that BMD as measured by DEXA is a useful but imperfect predictor of fracture risk, and that low BMD may not always precede fractures in vertebral bones. Other factors such as bone quality (i.e., trabecular connectivity) should also be considered. The skeletal integrity of a vertebra may be compromised by the loss of key trabeculae, resulting in structural failure, but the spine may still show a BMD value within normal limits, or within the range of osteopenia.
Collapse
Affiliation(s)
- A M Cerroni
- Department of Anthropology, University of Toronto at Mississauga, Mississauga, Ontario L5L 1C6, Canada
| | | | | | | |
Collapse
|
39
|
Kunos CA, Simpson SW, Russell KF, Hershkovitz I. First rib metamorphosis: its possible utility for human age-at-death estimation. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1999; 110:303-23. [PMID: 10516563 DOI: 10.1002/(sici)1096-8644(199911)110:3<303::aid-ajpa4>3.0.co;2-o] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Human first ribs demonstrate predictable, sequential changes in shape, size, and texture with increasing age, and thus, can be used as an indicator of age at death. Metamorphosis of the first rib's head, tubercle, and costal face was documented in a cross-sectional sample of preadult and adult first ribs of known age at death from the Hamann-Todd skeletal collection (Cleveland Museum of Natural History, Cleveland, Ohio). Blind tests of the usefulness of the first rib as an age indicator were conducted, including tabulation of intraobserver and interobserver inaccuracies and biases. First rib age estimates show inaccuracies and biases by decade comparable to those generated by other aging techniques. Indeed, the first rib method is useful as an isolated age indicator. When used in conjunction with other age indicators, the first rib improves the quality of summary age assessments.
Collapse
Affiliation(s)
- C A Kunos
- Department of Anatomy, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
| | | | | | | |
Collapse
|
40
|
Affiliation(s)
- Nancy C. Lovell
- Department of Anthropology, University of Alberta, Edmonton, AB T6G 2H4, Canada
| |
Collapse
|
41
|
Seidemann RM, Stojanowski CM, Doran GH. The use of the supero-inferior femoral neck diameter as a sex assessor. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1998; 107:305-13. [PMID: 9821495 DOI: 10.1002/(sici)1096-8644(199811)107:3<305::aid-ajpa7>3.0.co;2-a] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The present study examines the sexing potential of the minimum supero-inferior femoral neck diameter in Caucasians and African-Americans who lived at the turn of the century. A Student's t-test and an ANOVA indicate that population differences in neck morphology exist, albeit the strength of the test is fairly weak (P = 0.015). Predictive models were developed using a linear discriminant function analysis for the African-American sample, the Caucasian sample, and the combined African-American and Caucasian (AAC) sample. Jackknifed classification matrices produced classification success rates ranging from 87 to 92%. Each of the three discriminant functions were evaluated using an independent, random holdout sample. Although a smaller holdout sample usually better approximates the true error involved in an application, this was clearly not the case in this study. For African-Americans, 28 of 28 individuals were correctly classified, for Caucasians 24 of 25, and for the combined AAC sample 53 of 53 individuals were sexed correctly. It is more likely that the true accuracy of the model for the population approximates 90%. This accuracy combined with the high rate of preservation of the femoral neck makes this measurement useful in extremely fragmentary samples.
Collapse
Affiliation(s)
- R M Seidemann
- Department of Anthropology, Florida State University, Tallahassee 32306, USA.
| | | | | |
Collapse
|
42
|
Abstract
Humans are constantly at risk of bone fractures, not only when threatened by personal violence, but also by the challenge of daily living. Because fractures are a cross-cultural phenomenon and are one of the more commonly observed skeletal lesions in archaeological collections, their presence provides a unique opportunity to compare living conditions, and thereby assess fracture risk in coexisting cultures. This study analyzed long bone fracture patterns of 212 sexed adults from the medieval leper hospital of St. James and St. Mary Magdalene in Chichester, England. The comparison of this hospital sample to other British medieval skeletal samples examined the level of health manifest in fracture etiology. The fracture frequency for this sample was 15.1%, with males accounting for 85.4% of the fractures. The fracture frequencies from the samples not affiliated with hospitals ranged from 3.3 to 5.6%. Because medieval urban lifestyle was notoriously difficult due to inadequate sanitation and living conditions, the overall health of the population at large was inferior, placing all at similar fracture risk. Therefore, more specific complications associated with the fractures were examined. Osseous modifications of the skeletons due to lepromatous leprosy were associated with 28% of individuals sustaining fractures. However, persons with the milder tuberculoid leprosy do not exhibit skeletal lesions, but are more prone to accident due to the earlier loss of sensory perception and visual impairment. It is argued that the presence of leprosy is underestimated in archaeological populations and may be a major contributing factor to the prevalence of fracture resulting from accidental falls.
Collapse
Affiliation(s)
- M A Judd
- Department of Anthropology, University of Alberta, Edmonton, Canada.
| | | |
Collapse
|
43
|
Life conditions of a roman imperial age population: Occupational stress markers and working activities inLucus Feroniae (Rome, 1st–2nd cent. AD). ACTA ACUST UNITED AC 1997. [DOI: 10.1007/bf02438179] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
44
|
Affiliation(s)
- Nancy C. Lovell
- Department of Anthropology, University of Alberta, Edmonton, AB T6G 2H4, Canada
| |
Collapse
|
45
|
Rothschild BM, Rothschild C. Comparison of radiologic and gross examination for detection of cancer in defleshed skeletons. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1995; 96:357-63. [PMID: 7604891 DOI: 10.1002/ajpa.1330960404] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The reliability of visual examination of defleshed bones was assessed for detection of postcranial metastatic disease in individuals known to have had cancer. This was compared with standard clinical radiologic techniques. The skeletons of 128 diagnosed cancer patients from an early 20th century autopsied skeletal collection (Hamann-Todd Collection) were examined. Radiologic examination detected evidence of metastatic disease in 33 individuals, compared to 11 by visual examination of the postcranial skeletons. Four of these cases were detected by both techniques. Blastic lesions were most commonly overlooked on visual examination, because they were localized to trabecular (internal bone) structures. The ilium was the most commonly affected bone, with lytic or blastic lesions detected in 30 of 33 individuals. While the proximal femur was affected in only nine individuals, x-ray of the proximal femur and ilium detected all individuals with postcranial evidence of metastatic disease. Skeletal distribution of metastases provides no clue to the location of origin or histologic subtype of the cancer. Survey of archeological human remains for metastatic cancer requires radiologic examination. Such skeletal surveys should x-ray at least the ilia and femora.
Collapse
Affiliation(s)
- B M Rothschild
- Arthritis Center of Northeast Ohio, Youngstown 44512, USA
| | | |
Collapse
|
46
|
Macchiarelli R, Bondioli L. Linear densitometry and digital image processing of proximal femur radiographs: implications for archaeological and forensic anthropology. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1994; 93:109-22. [PMID: 8141239 DOI: 10.1002/ajpa.1330930108] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Age- and sex-related patterns of proximal femur trabecular bone loss have previously been used to establish radiographic reference standards for estimating age at death for human skeletal remains. Such standards are of interest to both anthropologists and forensic scientists. However, osteopenia as a physiological phenomenon is dependent on numerous genetic, environmental, and cultural factors. Thus, while general age- and sex-related trends can be clearly observed for trabecular bone loss, such patterns also demonstrate marked variation among individuals of both sexes at all ages. Moreover, clinical evidence shows that rates of bone loss are not steady but episodic, and that radiographically "normal" (i.e., young adult) patterns of trabecular bone architecture can also exist in femora of older individuals, particularly within samples of African origin. In this study, adult proximal femur radiographs were used to explore patterns of age- and sex-related proximal femur cancellous bone involution among a sample of 66 African-American individuals from the Terry collection (33 males and 33 females), ranging in age from 19 to 71 years. The proximal femur radiographs of these subjects were analyzed by digital image processing (DIP), and the results were compared to those obtained by laser linear densitometric analyses (LDA) previously performed on the same series (Macchiarelli et al., 1987). Results of LDA and DIP analyses indicate (a) more pronounced bone density decrease in females; (b) sex- and site-specific structural patterns of proximal femur trabecular bone loss; (c) a high level of individual variability, in which predicted age deviated from real age by as much as 22.26 (males) and 30.78 years (females); (d) a moderate linear correlation with age for all the variables analyzed; and (e) an average discrepancy between known age and predicted age (measured by root mean squared residual values) of 10.34 (males) and 12.71 years (females) for the most satisfactory DIP analysis parameter (recorded at the center of the femoral neck in the equalized images). With regard to estimating adult age at death from radiographic images of proximal femora, it is argued that the amount of useful age information reported for this criterion has been overestimated.
Collapse
Affiliation(s)
- R Macchiarelli
- Museo Nazionale Preistorico Etnografico, L. Pigorini-Sezione di Antropologia, Rome, Italy
| | | |
Collapse
|
47
|
Rothschild BM, Woods RJ. Spondyloarthropathy: erosive arthritis in representative defleshed bones. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1991; 85:125-34. [PMID: 1882978 DOI: 10.1002/ajpa.1330850202] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Erosive changes and syndesmophyte formation, characteristics of spondyloarthropathy, were present in 79/2906 skeletons in the Todd Collection. Holistic assessment of this defined population allowed it to be distinguished from rheumatoid and other erosive forms of arthritis. Characterization of the nature and distribution of osseous alterations in a contemporary skeletal population allowed development of a standard for recognition of the disease in skeletal populations.
Collapse
|
48
|
Formicola V, Frayer DW, Heller JA. Bilateral absence of the lesser trochanter in a late Epigravettian skeleton from Arene Candide (Italy). AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1990; 83:425-37. [PMID: 2275480 DOI: 10.1002/ajpa.1330830404] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A virtually complete skeleton recovered from excavations in a Late Upper Paleolithic context by Cardini between 1940 and 1942 at the Arene Candide cave (NW Italy) lacks the normal development of the left and right lesser trochanters. The specimen is a short-statured male about 25 years old and shows no other especially peculiar skeletal irregularities, except for high negative angles of femoral torsion. We discuss a number of possible etiologies for the anomalous absence of the lesser trochanters. The condition is most likely a result of an epigenetic effect or a traumatic avulsion of both lesser trochanters. If the absence of normal development of the lesser trochanters involves a congenital condition, it is an extremely rare, previously undescribed trait. If the condition results from bilateral traumatic avulsion, it is probably the result of excessive muscular stress on the proximal femur and provides further evidence of hardship of life in Paleolithic populations and of the ability of these people to survive debilitating trauma.
Collapse
Affiliation(s)
- V Formicola
- Dipartimento di Scienze del Comportamento Animale e dell'Uomo dell'Università, Pisa, Italy
| | | | | |
Collapse
|