Skeletal pathology Lecture 8 Flashcards
anatomy of the bone
bone marrow
spongy bone
compact bone
blood vessels
joint diseases
• Degenerative Joint Disease (DJD) most commonly observed pathological change in archaeological assemblage
• Numerous types of joint disease (arthropathies)
– osteoarthritis
– diffuse idiopathic skeletal hypoerostosis (DISH)
– gout
– rheumatoid arthritis
Osteoarthritis
OA can affect one (monoarticular) or many (polyarticular) joints
Primary and secondary
Affects each person differently
Multifactoral – associated with age, overweight, injury, stresses on joint, virus related
Three major skeletal symptoms:
1. Breakdown of articular cartilage,
leading to abrasion of subchondral bone, i.e. bone below the cartilage
2. Reactive bone formation in the subchondral compact bone (eburnation) and in trabeculae
3. New growth of cartilage and bone at joint margins
(osteophytes)
Rheumatoid arthritis
• Chronic inflammatory disease of synovial joints • Multiple joint involvement • Commonly bilateral and symmetric • Erosive lesions (little indication of healing) • Predominantly hands and feet • Marked osteoporosis and ankylosis distinguishing features • Systemic effects • Bone lesions – rounded edges • X -ray – marginal erosions and periarticular osteopaenia Rheumatoid
Diffuse idiopathic skeletal hyperostosis (DISH)
- Production of excessive amounts of bone at joint margins and entheses (muscle insertions)
- Spine markedly affected – particular fusion identified as ‘candlewax’
- Four or more vertebrae must be fused to be classed as DISH
- Age related disease (over 50 years)
- Associated with a protein -rich diet and obesity
- Awareness of disease - stiff back
- Right side
- Twice as common in males than females
- Associated with obesity and diabetes (type II)
gout
• Associated with elevated serum levels
of urate (uric acid)
• Well patterned distribution of urate
crystals
• Distinctive lytic (destructive) lesions
• Usually only one joint affected
• Most commonly first metatarsal phalangeal joint
• Intense local inflammation
• Very painful
• Associated with more affluent of society
neoplasm
• Neoplasm: ‘new growth’
• Benign or malignant
• Type of tumour :
– bone
–cartilaginous masses (chondromas) – located in the bone or on surface
–connective tissue (component of all principle parts of bone structure (medulla, cortex and periosteum)
Congenital abnormalities
• Congenital anomalies or malformations are
produced by pathological changes during development
• Observed at birth or in later life
• Hereditary
• Any organ may be affected and the skeleton is
affected in a high percentage of cases
• Minor defects, severe defects and lethal
examples of congenital abnormalities
scoliosis
kyphosis
scoliosis
congenital abnormality
• lateral curvature of the spine with rotation of spinous processes towards the concavity
• multiple aetiology but probably inherited & linked to X chromosome
kyphosis
congenital abnormality
• angular deformity of the spine with convexity
dorsally with angulation in excess of 40 degrees
• aetiology remains obscure – hereditary factors
probably play a role
infections
- Non -specific infections very common in archaeological material
- Inflammation of periosteum
- Different episodes of healing/ remodelling observed on bone surface
- Specific infections increase in Industrial Revolution period
- Tuberculosis and syphilis – readily identifiable but diagnosis can be hindered by missing elements
- Smallpox – mass killer but little skeletal evidence as acute
- Leprosy – historical sources relating to disease as mass killer – some examples but not on scale indicated by history
metabolic disorders
rickets
scurvy
Osteoporosis
trauma
• Can be – Accidental – Interpersonal – Pathological –Blunt and sharp force trauma
