A case of secondary hypertrophic osteoarthropathy from medieval Tuscany (central Italy, 10th-12th centuries CE)

IF 1.3 3区 地球科学 Q3 PALEONTOLOGY International Journal of Paleopathology Pub Date : 2023-09-22 DOI:10.1016/j.ijpp.2023.09.004
Valentina Giuffra , Simona Minozzi , Giacomo Aringhieri , Stefano Campana , Giulia Riccomi
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Abstract

Objectives

This study aims to provide a detailed evaluation of a case of secondary hypertrophic osteoarthropathy (HOA) and to explore insights into the presence and consequences of disease in medieval rural Italy.

Materials

The skeleton of a male (US 4405) with an estimated age at death of 51–69 years excavated from the medieval rural site of Pieve di Pava (Siena, Italy).

Methods

Macroscopic and radiological (x-ray, CT) analyses were performed.

Results

Symmetrical extensive periosteal new bone formation on the diaphyseal and metaphyseal regions of this individual’s long bones; the lower limbs were more extensively and severely affected than the upper limbs and the distal segments were more severely altered in comparison to the proximal ones.

Conclusions

The macroscopic and radiological features are highly consistent with a diagnosis of secondary HOA.

Significance

The excellent state of preservation allowed the evaluation of rarely noted skeletal manifestations of HOA and provided insight into aspects of rural life in medieval Italy.

Limitations

Molecular analysis was not successful in sequencing the aDNA of tuberculosis, therefore the underlying primary cause of secondary HOA, whether pulmonary or extrapulmonary, remains obscure in this case.

Suggestion for the future research

It is advisable to regularly revisit the data available from osteoarchaeological collections in order to identify further cases of HOA, along with to further investigate the known cases to search for the underlying primary disease.

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一例来自中世纪托斯卡纳(意大利中部,公元10至12世纪)的继发性肥大性骨关节病。
目的:本研究旨在对一例继发性肥大性骨关节病(HOA)进行详细评估,并探讨该疾病在意大利中世纪农村的存在和后果。材料:从意大利锡耶纳Pieve di Pava中世纪农村遗址挖掘的一具男性(US 4405)的骨骼,估计死亡年龄为51-69岁。方法:宏观和进行放射学(x射线、CT)分析。结果:在该个体长骨的骨干和干骺端区域形成对称的广泛骨膜新骨;下肢受到的影响比上肢更广泛、更严重,远端节段与近端节段相比变化更严重。结论:宏观和放射学特征与继发性HOA的诊断高度一致。意义:良好的保存状态使人们能够评估罕见的HOA骨骼表现,并深入了解中世纪意大利农村生活的各个方面。局限性:分子分析未能成功测序肺结核的aDNA,因此,继发性HOA的根本原因,无论是肺还是肺外,在这种情况下仍然不清楚。对未来研究的建议:建议定期重新访问骨考古收集的数据,以确定更多的HOA病例,同时进一步调查已知病例,寻找潜在的原发性疾病。
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来源期刊
CiteScore
2.90
自引率
25.00%
发文量
43
期刊介绍: Paleopathology is the study and application of methods and techniques for investigating diseases and related conditions from skeletal and soft tissue remains. The International Journal of Paleopathology (IJPP) will publish original and significant articles on human and animal (including hominids) disease, based upon the study of physical remains, including osseous, dental, and preserved soft tissues at a range of methodological levels, from direct observation to molecular, chemical, histological and radiographic analysis. Discussion of ways in which these methods can be applied to the reconstruction of health, disease and life histories in the past is central to the discipline, so the journal would also encourage papers covering interpretive and theoretical issues, and those that place the study of disease at the centre of a bioarchaeological or biocultural approach. Papers dealing with historical evidence relating to disease in the past (rather than history of medicine) will also be published. The journal will also accept significant studies that applied previously developed techniques to new materials, setting the research in the context of current debates on past human and animal health.
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