Bioarchaeology in the ancientNearEast: Challenges and future directions for the southern Levant

Differential diagnosis of metabolic disease in a commingled sample from 19th century Hisban, Jordan

OBJECTIVE

This research attempts a differential diagnosis of skeletal lesions in a commingled sample from Hisban, Jordan, focusing on non-adults in the assemblage.

MATERIALS

2,883 well-preserved skeletal elements and 9 relatively complete skulls representing an MNI of 32 non-adults (<18 years old).

METHODS

All skeletal elements were observed macroscopically and pathophysiological processes underlying any lesions or other anomalies were assessed, followed by a comparative approach to rule out potential diagnoses.

RESULTS

The skeletal lesions observed were caused by inflammation due to chronic hemorrhaging, marrow hyperplasia due to an increase in hemopoiesis, rapid bone growth, and the impact of biomechanical strain on poorly mineralized elements. Rickets, scurvy, and acquired anemias best fit this pattern of lesions, although inflammation from other sources such as trauma or infection could not be definitively ruled out.

CONCLUSIONS

The in utero and postnatal environments at Hisban were conducive to the development of vitamin C and D deficiencies from birth until 2 years of age. The analysis of commingled remains requires an ontological shift in the importance of the individual to the population in paleopathology.

SIGNIFICANCE

This investigation demonstrates the efficacy of a combined biological and comparative approach in differential diagnosis in complicated commingled collections. In addition, it emphasizes the importance of the mother-infant dyad in understanding metabolic disease.

LIMITATIONS

Histological and radiographic analyses were not included in this diagnostic study due to COVID-19 travel restrictions.

SUGGESTIONS FOR FURTHER RESEARCH

Isotopic analysis to investigate childhood diet and histological and radiographic analyses to assess survival of deficiencies.

A microarchitectural assessment of the gluteal tuberosity suggests two possible patterns in entheseal changes

OBJECTIVES

Macroscopic entheseal forms show two main features: predominant signs of bony formation or resorption. To understand the development of these forms, we investigated microarchitectural differences between the macroscopic proliferative and resorptive forms of the gluteus maximus enthesis.

MATERIALS AND METHODS

The macromorphological analysis of entheseal changes (EC) was based on the Villotte, visual scoring system for fibrous entheses. Gluteal tuberosity specimens of different stages of Villote's system were harvested from 16 adult males derived from an archaeological context and scanned using microcomputed tomography.

RESULTS

The microarchitectural analyzes of cortical bone demonstrated a trend of higher porosity in the resorptive compared to the proliferative phase in Stage B, whereas a 30% porosity reduction was detected in the resorptive compared to proliferative phase of Stage C. In terms of the trabecular bone between the resorptive and proliferative entheseal phases, there was a trend of increased connectivity density, whereas the structural model index decreased in B and increased in C. The assessment of the entire specimen showed an increase in porosity from the proliferative to the resorptive phase in the Stage B, in contrast to a decrease in the Stage C.

DISCUSSION

The results suggest that from an initial flat entheses, two directions of EC development are possible: (a) a bony prominence may form and, subsequently, it is subjected to trabecularization of the cortical bone inside the prominence, such cortical trabecularization can lead to visible porosity on the cortical external surface; (b) the cortical bone defect may develop with the regular underlying cortical bone.

Commingled crypts: Comparative health among Byzantine monastics in the Levant

OBJECTIVES

Early Byzantine (A.D. 330-842) monastic rules stipulated that entrants relinquished familial connections, personal belongings and secular relationships to become part of the ascetic collective that continued in death, resulting in bioarchaeological marginalization, as was the case of the monastics excavated from the Chapel of Robebus at Mount Nebo, Jordan (ca. A.D. 491-640). It was hypothesized that compared to contemporary monastic groups, the Mount Nebo monastics experienced poorer health and gravitated to Mount Nebo, owing to its association with the Prophet Moses and proximity to the Dead Sea, Livias baths and Jordan River, all associated with curative benefits, especially for those suffering from leprosy.

MATERIALS AND METHODS

The commingled remains of 73 adult males from Mount Nebo and the articulated skeletons (n = 27) from the Sanctuary of Agios Lot at Deir 'Ain 'Abata (Jordan) were assessed for paleopathology, then compared with a contemporary commingled group from the Monastery of Saint Euthymius at Khan-el-Ahmar (Judean Desert) (n = 117).

RESULTS

No skeletal evidence of leprosy was observed among the groups. Most Mount Nebo individuals did not reach an older age, yet injuries, severe osteoarthritis, lower leg osteoperiostitis and antemortem tooth loss were common. The paleopathological profile was similar at Deir 'Ain 'Abata, but paleopathology was negligible at Khan-el-Ahmar.

CONCLUSIONS

The similar paleopathological profiles of the Jordanian monastic groups suggest that the proximity to the Dead Sea may have attracted monastics to both sites, in addition to spirituality, but leprosy was not a factor based on the skeletal evidence.

Is differential diagnosis attainable in disarticulated pathological bone remains? A case-study from a late 19th/early 20th century necropolis from Juncal (Porto de Mós, Portugal)

Differential diagnosis is a fundamental step in every palaeopathological study. It is a challenging exercise since many intrinsic and extrinsic factors may negatively impact the accurate interpretation of bone changes in human skeletal remains. Among these, the completeness and preservation of skeletal elements plays a significant role. This study aims to explore the limits of differential diagnosis in the analysis of disarticulated, fragmented bones. The sample consists of twelve adult bone fragments with noticeable changes. The remains were identified in a dis-articulated skeletal assemblage from the former necropolis of Juncal (Porto de Mós, Portugal), which probably closed in the late 19th century/early 20th century. They were analysed visually and with X-radiography, and the changes carefully described prior to differential diagnosis. Six bones presented signs of healed bone trauma and one showed features compatible with leg amputation. Periosteal reactions were observed in several bones, one of them resembling changes consistent with an overlying skin ulcer. Two bone fragments were identified as belonging to the same individual due to the matching bone changes. Despite the incomplete remains, a broader diagnosis was possible for most cases, which facilitated a discussion of health, medical and social care among the inhabitants of the region.