背靠背:来自波兰早期现代的DISH和强直性脊柱炎的共同发生

IF 1.3 3区 地球科学 Q3 PALEONTOLOGY International Journal of Paleopathology Pub Date : 2023-03-01 DOI:10.1016/j.ijpp.2022.11.002
Tracy K. Betsinger , Amy B. Scott
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引用次数: 2

摘要

目的:本病例研究评估与DISH和强直性脊柱炎相一致的骨骼变化。我们在这里提出了个人的病理骨骼变化的评估和潜在的诊断回顾。最后,我们提供鉴别诊断的合并症罕见的发现在古病理记录。材料:在现代波兰早期(公元17 -18世纪)德鲁斯科1号遗址发现的一具年龄在50岁以上的男性骨骼遗骸。方法对骨骸进行脊柱关节病检查。结果患者表现为T6-T10椎体前外侧融合,呈“滴烛蜡”状,右侧8肋肋椎体关节融合,左侧T8-T10椎体突起关节融合,T3-T4棘上韧带钙化。左侧骶髂关节显示关节内和关节旁融合;右侧骨变化与持续的融合一致。左锁骨、肩胛骨、第一掌骨、尺骨和肱骨均出现骨内反应。弥漫性特发性骨骼增生症(DISH)、强直性脊柱炎(AS)、反应性关节炎(RA)、银屑病关节炎(PA)和肠病性关节炎(EA)被认为是鉴别诊断。结论根据受累的骨骼类型,该患者同时患有DISH和AS,这在1950年以来的古病理学文献中已有报道。临床文献表明,这两种情况可能同时发生,大约有40人受到影响。意义本病例研究在古病理记录中证明了DISH和AS的共同发生。此外,本病例有助于理解异质性虚弱和综合症。局限性:未采用x线片进行鉴别诊断。未进行aDNA分析。对进一步研究的建议遗骸已被重新掩埋;无法进一步分析。
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Back-to-back: The co-occurrence of DISH and ankylosing spondylitis from early modern Poland

Objective

This case study evaluates an individual with skeletal changes consistent with DISH and ankylosing spondylitis. We present here an evaluation of the individual’s pathological skeletal changes and a review of the potential diagnoses. Finally, we offer a differential diagnosis of co-morbidity infrequently found in the paleopathological record.

Materials

The skeletal remains of a male, aged 50 + years from the early modern Polish (17th-18th century CE) site of Drawsko 1.

Methods

Skeletal remains were examined for the presence of spondyloarthropathies.

Results

The individual presented with anterolateral fusion of the vertebral bodies of T6-T10 with a “dripping candle wax” appearance, fusion of the right costovertebral joint at rib 8, fusion of the left apophyseal joints of T8-T10, and the calcification of the supraspinous ligament at T3-T4. The left sacroiliac joint shows intra-articular and para-articular fusion; the right has bony changes consistent with ongoing fusion. Entheseal reactions were noted on the left clavicle, scapulae, first metacarpals, ulnae, and humerii. Diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis (AS), reactive arthritis (RA), psoriatic arthritis (PA), and enteropathic arthritis (EA) are considered as differential diagnoses.

Conclusions

Based on the skeletal pattern of involvement, the individual suffered from both DISH and AS, which has previously been reported once in the paleopathological literature since 1950. The clinical literature indicates that co-occurrence of these two conditions is possible, with approximately 40 individuals affected.

Significance

This case study is significant for demonstrating the co-occurrence of DISH and AS in the paleopathological record. Additionally, this case contributes to the understanding of heterogenous frailty and syndemics.

Limitations

No radiographs were taken to confirm the differential diagnosis. No aDNA analysis was conducted.

Suggestions for further research

The remains have been reburied; no further analysis is possible.

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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.
期刊最新文献
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