Paleoradiology Imaging Mummies and Fossils

R. K. Chhem · D. R. Brothwell Paleoradiology R. K. Chhem · D. R. Brothwell Paleoradiology Imaging Mummies and Fossils With 390 Figures and 58 Tables 123 Don R. Brothwell, PhD Department of Archaeology The University of York The King’s Manor York Y01 7EP UK Rethy K. Chhem, MD, PhD, FRCPC Department of Diagnostic Radiology and Nuclear Medicine Schulich School of Medicine and Dentistry University of Western Ontario London Health Sciences Centre 339 Windermere Road London, Ontario N6A 5A5 Canada Library of Congress Control Number: 2007936308 ISBN 978-3-540-48832-3 Springer Berlin Heidelberg New York This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. 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Editor: Dr. Ute Heilmann, Heidelberg, Germany Desk Editor: Meike Stoeck, Heidelberg, Germany Production: LE-TEX Jelonek, Schmidt & Vöckler GbR, Leipzig, Germany Reproduction and typesetting: Satz-Druck-Service (SDS), Leimen, Germany Cover design: WMX Design, Heidelberg, Germany Printed on acid-free paper 24/3180/YL 5 4 3 2 1 0 Foreword The Radiologist’s Perspective It is my pleasure to write the foreword to this groundbreaking text in paleoradiology. Dr. Rethy Chhem is a distinguished musculoskeletal radiologist, and he is the founder of the Paleoradiologic Research Unit at the University of Western Ontario, Canada, and the Osteoarchaeology Research Group at the National University of Singapore. His special area of paleoradiologic expertise is the Khmer civilization of Cambodia, and his contributions to radiologic and anthropologic science have built bridges between these two not always communicative disciplines. Dr. Don Brothwell is of course well known to the paleopathology communi- ty. He is something of an anthropologic and archaeologic polymath, having made important contributions to dental anthropology, the antiquity of human diet, and veterinary paleopathology, among others. His textbook, “Digging Up Bones” (Brothwell 1982), has introduced many generations of scholars to bioarchaeology, a discipline of which he is one of the founders. It is only fitting that this book is the work of a radiologist and an anthropologist, both of whom have experience in musculoskeletal imaging and paleopathology. For more than 100 years, diagnostic imaging has been used in the study of ancient disease. In fact, one of the first comprehensive textbooks of paleopathology, “Paleopathologic Diagnosis and Interpre- tation,” was written as an undergraduate thesis by a nascent radiologist, Dr. Ted Steinbock (Steinbock 1976). The advantages of diagnostic imaging in paleopathologic research should be intuitively obvious. Osseous and soft tissue may be noninvasively and nondestruc- tively imaged, preserving original specimens for research and display in a museum setting. Not only will the original material, often Egyptian mummies, be preserved for future generations of researchers, but public enthusiasm will be fostered by the knowledge that we can see what is really underneath all those wrappings. Recent advances in computed multiplanar image display present novel ways to increase our understanding of the individuals, the processes of mummification and burial, and the cultural milieu in which these people lived. Unfortunately, although the potential of radiology has been recognized, the realization of collaborative effort has been inconsistent. The earliest use of radiography in paleopathology was in the diagnosis of specific diseases in individuals, much as it is in clinical medicine today. Egyptian mummies were radiographed as early as 1896. Comprehensive studies of mummy collections were performed in the 1960s and 1970s, culminating in the exhaustive treatise by Harris and Wente, with important contributions by Walter Whitehouse, MD, in 1980 (Harris and Wente 1980). The usefulness of radiologic analysis of collections of such specimens led to the realization that diagnostic imaging has important im- plications in paleoepidemiology as well as in the diagnosis of individual cases. Technical innovations in radiology have paralleled progress in paleopathology. We are now able to perform per three-dimensional virtual reproductions of the facial characteristics so that mummies do not have to be unwrapped, and we can now carry out “virtual autopsies” using three-dimensional computed tomography as a guide. We are now also using modern imaging technology to go beyond pic- VI Foreword tures. It is well established that radiologic and computed tomographic evaluation, in conjunction with physical anthropologic and orthopedic biomechanical data, may yield important biomechanical information in such studies as noninvasive measurement of the cross-sectional area of long bones to compare biomechanical characteristics in different populations such as hunter-gatherers and agricultura- lists, and to study the mechanical properties of trabecular bone. This textbook represents a significant advance in the effort to engage clinical physicians, especially radiologists and paleopathologists in a dialogue. Although there have been many such attempts in the past, they have for the most part dealt with specific imaging findings to diagnose disease in specific ancient remains. Chhem and Brothwell have given us the opportunity to go beyond this type of ad hoc consultation by presenting a systematic approach to the radiologic skeletal dif- ferential diagnosis of ancient human and animal remains. However, I believe that the intent of the authors is not so much to have paleopathologists interpret these finding in a vacuum, but rather to understand the capabilities of musculoskeletal radiologists, not only to assist with diagnosis, but also to offer information about the clinical setting in which these diseases occur and to suggest other appropriate imaging technology. For their part, musculoskeletal radiologists should be able to use this text to understand the context in which paleopathologists work, including taphonomic change, and to appreciate the rich legacy of diagnostic imaging in biological anthropology and archaeology. Along with the authors, I hope that radiologists and biological anthropologists will use this textbook to translate both the radiologic and anthropologic idiom to better comprehend the other’s potential for collaboration. Once we establish a common language, it will be easier to solve the diagnostic problems and dilemmas we share. Doctors Chhem and Brothwell are to be congratulated for taking that important first step. Ethan M. Braunstein References Brothwell DB (1982) Digging up Bones (3rd edn). Cornell University Press, Ithaca Steinbock RT (1976) Paleopathologic Diagnosis and Interpretation. Charles C. Thomas, Spring- field, Illinois, p 423 Harris JE, Wente EF (1980) An X-Ray Atlas of the Royal Mummies. University of Chicago Press, Chicago, Illinois, p 403 Foreword The Anthropologist’s Perspective The study of human paleopathology has benefited from the use of radiological methods for many decades. However, the use of radiological images and interpreta- tive insights has in earlier years tended to be limited to medical professionals with expertise and experience in interpreting radiographic images as well as having access to the necessary equipment to produce radiographs in the hospitals where they worked. As the diagnostic value of radiology in the evaluation and diagnosis of disorders in archaeological human and nonhuman remains became more appar- ent, plain-film radiological facilities were established in many nonmedical centers where research on these remains was a central part of their scientific endeavors. With greater access to radiographic data on paleopathological specimens, biological anthropologists became increasingly competent in interpreting these images. However, there remain very important reasons why ongoing collaboration between radiologists and biological anthropologists in the analysis of paleopathological cases continues to be a valuable contribution to science. One of the troublesome limitations of plain-film radiology is that three-dimensional anatomical features are projected onto a single plain. The inevitable super- imposition that occurs can obscure important details of a radiographic image, adding to the challenge of interpretation. With the advent and widespread use of computed tomography (CT) radiological methods as an important diagnostic tool in clinical radiology, these methods began to be applied to archaeological remains.

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