Definition Paleopathology

Traumatic Lesions “The science of the disease Artificial Intervention which can be demonstrated Neoplastic Lesions inin human and animal remains Metabolic Lesions of ancient times.” Degenerative Lesions Congenital Abnormalities Sir Marc Armand Ruffer, 1913 InfectiousInfectious LesionsLesions InflammatoryInflammatory LesionsLesions

Methods Postmortem??

Gross Findings Rehydration Dissecting Light Microscopic Findings Electron Serological Studies Scanning Electron Chemical Studies

Trauma fracture Fracture patterns

Transverse Oblique Spiral Comminuted

1 Fracture healing

Trauma New Blood New Bone Blood Clot New Bone Fracture Vessels Formation Callus

Woven bone Fracture callus on juvenile radius

dislocation

Trauma

2 Artificial Intervention

Cradle Boarding - Peru -

Perry’s & Collies Fractures

Tumpline deformation Tumpline deformation

Incomplete TrepAnationS TrepAnationS

TrepAnation Healing

3 Modern TrepAnationS Modern TrepAnationS

Decoration False Teeth Pre- and Post-Mortem Peruvian skull with agate teeth

Neoplastic Lesions

Age Benign Lesions Malignant Tumors Ewing’s sarcoma 0-10 simple bone cyst leukemic involvement eosinophilic granuloma metastatic neuroblastoma fibrous dysplasia simple bone cyst osteochondroma (exostosis) osteosarcoma 10-20 osteoid osteoma Ewing's sarcoma osteoblastoma adamantinoma chondroblastoma chondromyxoid fibroma

enchondroma chondrosarcoma 20-40 giant cell tumor

metastatic tumors myeloma leukemic involvement osteoma 40 & up chondrosarcoma Surgical Repair osteosarcoma chordoma

4 TYPES OF Giant Cell Tumors TUMORS

Multiple Myeloma

Osteoma

Vitamin Deficiencies Metabolic Lesions

Vitamin & Mineral Deficiencies Toxic Intakes Generalized Stress Indicators Childhood Stress Indicators Vitamin D deficiency Epiphyseal stunting Softened bones

5 Cribra orbitalia Gout Diploic thickening

IronIron deficiency Porotic Hyperostosis Uric acid crystals Part of syndrome Porotic Hyperostosis

General stress indicatorsindicators Congenital Lesions

Gigantism Hydrocephaly Club Foot Achondroplasia Enamel hypoplasias Spina bifeda Harris Lines Gigantism Gigantism

6 Hydrocephaly Hydrocephaly

Club Foot Achondroplasia Achondroplasia

7 Infectious Lesions

Trepanematosis Treponema pallidum, T. pertineu

Tuberculosis Mycobacterium tuberculosis Spina bifeda Occulta Leprosy Mycobacterium leprae

Treponemal Disease Syphilis, Yaws, Bejel Venereal syphilissyphilis Endemic syphilissyphilis Yaws Trepanematosis

Soft Tissue

Worldwide Distribution

8 Tuberculosis Tuberculosis

Tuberculosis TB Treatments

Tuberculosis Treponematosis Tuberculosis Treponematosis Initial Lesions Lungs, lymph nodes Skin, mucous tissues Mycobacterium Treponema pallidum; Pathogenesis tuberculosis Treponema pertenue Any organ Mucous tissues, bone 2° Lesions system Respiration, Skin contact Mode of Infection aspiration Prevalence of 10-50% of exposed 100% of exposed Clinical Disease individuals individuals Modal Age at Infection Early childhood Early childhood Bone Lesions 3-15% prevalence 25-50% prevalence Late adolescence, Early childhood Modal Age of Disease early adulthood Major: lytic Major: blastic Response Minor: blastic Minor: lytic Duration of Infectious Intermittent c. 5-10 years throughout life Stage Mortality High Low Potential InformationInformation courtesy of Mary Lucas Powell, Ph.D. InformationInformation courtesy of Mary Lucas Powell, Ph.D.

9 Leprosy

leprosy

leprosy

Hansen’s Disease Mycobacterium lepraeleprae

70% inin India,India, Periostitis Mynmar, & Nepal

Rheumatoid Arthritis Inflammatory Lesions

10 Degenerative Lesions osteoArthritis

N Most common form of arthritis Osteoarthritis N Joint pain, cartilage degeneration, osteophytes Osteoporosis/Osteopenia N Repeated microtrauma to articular cartilage “Occupational Stress” N Little inflammation of synovial lining N Degenerative, not inflammatory

N Also called DJD

Etiology of osteoArthritis Degenerative Joint Disease

Normal loadload on Abnormal loadload abnormal jointjoint on normal jointjoint

Genetic defect Excessive load in cartilage injury

Result

Joint pain disability Loss of articular cartilage Bony remodeling

Osteophytosis

11 Osteoporosis vs Osteopenia Osteopenia

Bone mineral density cut-off points for osteopenia and osteoporosis

Osteoporosis

Osteoporosis vs. Osteopenia

Age-related bone loss

12 Differential Diagnosis??

Differential Diagnosis?? Differential Diagnosis ??

Differential Diagnosis ?? Differential Diagnosis ??

13 Differential Diagnosis ??

14