Terms in Paleopathology Flashcards

Terms Definitions
Osteomyelitis: Adults
-Disease: Tuberculosis, Syphilis,
Leprosy, ect.
- Bacteria (any bacteria that weakens the immune system): Staphylococcus aureus, Streptococcus
-Intravenous drug abuse
-Diabetes (peripheral vascular
disease): 30% of cases
-Age: After the age of 40
FOP: Clinical Perspective
Fibrodysplasia Ossificans Progressiva
--2 Features define classic FOP
>Malformation of big toes
>Extensive heterotopic ossification: Ossification outside skeleton
--Birth: Individuals appear normal at birth except for toe
--During first decade:
◦ Painful, inflammatory soft tissue
swellings◦Nodules◦Transform soft connective tissue into bone
> Aponeuroses
> Fascia
> Ligaments
> Tendons
> Skeletal muscles
◦ Does this through endochondral
-Osteo= bone; myelo= marrow; itis=inflammation
-Osteomyelitis is an infection in the bone marrow
>Inflammation is a secondary symptom of already infected medullary cavity
-It is a result of a weakened or compromised immune system caused by various factors (trauma, disease, bacteria)
TB: Skeletal
• Hematopoeitic tissue
• Differences in adults and children
• General characteristics
- Destruction
- Lytic lesions
- Little reactive bone formation
- Sequestra uncommon
- Osteopenia
- Healing and remodeling
- Collapse and ankylosis
• Most commonly involves spine, hip, knee
Leper Colonies: History
-Pre-relevant medical knowledge,
isolation of infected people
-Special hospitals or Live-in colonies
› Leprosaria (sing. lepersarium)
› Lazar houses
› Lazareto(s)
Abnormal smallness of the brain.
Trepanation Differential Diagnosis
-Tuberculosis, leisions look the same
L.O. Occasional symptom of
- Renal Osteodystrophy
-Acromegaly (gigantism)
O.I. Characteristics
-Insufficient amount of bone
-The organic bone matrix consists almost entirely of collagen,
therefore skeletal changes dominate the disease
-Cortical thickness & amount of trabecular bone are low
-Fractures can occur w/ apparently minor or even unrecognized force
-Fractures are typically transverse, occur on convex side of a bowed
long bone, & occur in femur more often than tibia!
-Excessive Wormian bones; however, absence of these does not rule out OI
Klippel-Feil Syndrome KFS
-Prevalence unknown; asymptomatic patients
- Patients may have pterygium
colli, a condition characterized by various degrees ofwebbing of the skin from the sides of the neck to the shoulders.
>bilateral:gives the appearance of a short neck
>unilateral: gives the appearance of a torticollis
-Torticollis is a shortening of the
sternoclcleidomastoid muscle that pulls the mastoid process toward thesternoclavicular joint on the same side.
>Also known as a twisted neck
AFIP: History
-19th-20th cen.did medical research: yellow fever, vacc for typhoid fever, STD transmission campaign
-WWII focus on pathology (1946) became apart of AIP
-AFIP does: diagnostic consultation, educationa and research (pathology).
-TNM (tumor node metastasis) project
Arising spontaneously or from obscure or unknown cause: Primary
1. Defective development or congenital absence of an organ or tissue.2. In hematology, incomplete, retarded, or defective development, or cessation of the usual regenerative process.
TB: Spine Diff. Diagnosis
• Differential diagnosis
- Osteomyelitis
- Healed compression fracture
- Ankylosing spondylitis
- Scoliosis
- Osteoporosis
- Blastomycosis,
- Malignant bone tumors
- Schmorls nodes
- Normal porosity
TB: Spine
• Most common and characteristic lesion
• Typical involvement
- Lower thoracic, upper lumbar region
- 2-4 adjacent vertebrae
- Anterior vertebral body
• Pott's disease
- Kyphosis, gibbus deformity
AS Differential Diagnosis: DISH
-Diffused Idiopathic Skeletal Hyperostosis
>No intervertebral disc disease
>Cause is unknown
>Rarely detected before40yrs
>2/3 case are males
> "Dripping candle wax"
OS: Survival
-Malignant: Early death; Bone cells can release hormone-like factors that cause cancer cells to grow faster
-Rate depends on treatment plan and metastasis: 20% survival with only surgery
Achondroplasia: Diagnosis
• Difficult to diagnose until
the 3rd trimester ( ≈ 21 weeks).
- Antenatal ultrasound/MRI
- DNA test before birth to
detect homozygosity
• General symptoms:
- Decreased muscle tone
- Short stature
- Disproportionately large
head‐to‐body size difference
Leprosy Transmission
-Most people have a natural immunity
- Not transmitted through casual exposure, sex, and doesn't cross placental barrier
-Respiratory tract
› Extent of exposure
› Environmental factors
› Degree of susceptibility
Animal carriers?
FOP: Cervical Manifestation
--Cervical Vertebrae
◦ Stiffness in neck early sign
◦ Large posterior elements
◦ Tall, narrow bodies
◦ Fusion of facet joints between
◦ C2 and C7
congenital deformity in which the head in somewhat triangular and flat
1. An anteriorly concave curvature of the vertebral column; the normal kyphoses of the thoracic and sacral regions are retained portions of the primary curvature (kyphosis) of the vertebral column.2. A forward (flexion) curvature of the spine; the thoracic spine normally has a mild kyphosis; excessive forward curvature of the thoracic spine may indicate a pathologic condition.
congenital deformity of the skull due to early synotosis of the parietal and occipital bones with compensating growth in the region of the anterior fontanel resulting in a pointed or pyramidal skull
Achondroplasia: Features
• Cranium: large cranial vault with small skull base
- prominent forehead (frontal bossing)w/ depressed nasal bridge
- narrowed foramen magnum
• Spine:posterior vertebralscalloping
- Spine curvatures: kyphosis and lordosis; widening of intervertebral discs; increased anglebetween sacrum & lumbar spine
• Chest: anterior flaring of ribs; anteroposterior narrowing of ribs
• Pelvis and hips: small squared iliac wings: "Tombstone"
- champagne glass type pelvic inlet
- short sacroiliac notches
• Limbs:Shortened femora and humeri: Rhizomeliac shortening, Thick appearance; Trumpet shape
- long fibula
- V shaped growth plates
• Hands:
- Abnormal hand appearance with
persistent space between the long and ring fingers: Trident shape
Achondroplasia: Causes
• a mutation in the fibroblast growth factor gene 3 (FGFR3)causing abnormal cartilage formation
- All bones formed by endochondral ossifica>on affected. Bones formed by membranous ossifica>on not affected
• Skull vault develops normally
• spontaneous mutations:
- two parents without achondroplasia may give birth to a baby with the condition.
• inherited as an autosomal dominant trait
- Defective gene from one parent = disorder
- one parent with achondroplasia = 50% chance of disorder.
- both parents with achondroplasia = 75% chance of disorder
Dental Modification: Inlays
-2nd most common form of
dental modification
- High prevalence in Mayan and
other Mesoamerican sites, also
seen in the Mississippian period
- Pyrite, jade, turquoise, and
gold were typical materials used
Leprosy: Geo Distribution Global
-Historically worldwide, sans arctic regions
-Today, primarily found in tropic and subtropical regions
-Highest concentrations in developing countries
-Leprosy is endemic in Asia, Africa, the Pacific basin,and Latin America (excluding Chile)
-Rural (opposite of historical)
Trepanation Healing: Short Term
-Evidence of osteoblastic activity surrounding areas of necrotic bone
-Hyper vascularity can sometimes be seen around the opening of the
-Individuals survived for at least a couple of week or even a few months
Osteogenesis Imperfecta (O.I)
- Brittle Bone disease
- Genetic disease
-Causes a person to have either less collagen than normal or a very poor quality of collagen
- OI affects 1 out of 30,000 people
Trepanation: Survival Rate
-For Oceania, survival has been estimated to be 50 % to as high as 90%
-W.J. McGee reported that his Peruvian skulls had a survival rate of 50%
Trepanation Reasons
- Cranial Injuries; done as an emergency procedure to relieve pressure/swelling
-Performed on the left side of the skull
-Males mostly because dealt in warfare
-Epileptic seizures patients
-was used to treat mastoiditis, which is a chronically painful inner ear infection
-Religious reasons
L.O. Controversy
- Researchers cant decide whether a syndrome/symptom of an associated disease/disease
Osteomyelitis: Historical treatment
- Only treated surgically
>drilled a hole through medullary cavity
>scraped the bone until blood came out
- Most common treatment amputation (civil war to get rid of infection)
Mature fusion of the sutures of the skull.
Cleidocranial dysostosis
A rare condition inherited as an autosomal dominant trait and characterized esp. by partial or complete absence of the clavicles, defective ossification of the skull, and faulty occlusion due to missing misplaced or supernumerary teeth.
L.O. Diff Diagnosis: Fibrous Dysplasia
- nonheritable congenital skeletal develp. disorder which leads to distortion of bone (expansion/weakening)
-Polyostotic form of F.D. looks like L.O.
TB Continuing Presence
Still present today
- Kills nearly 2m annually
- Comorbidity with HIV
- Reemergence with multiple drug-resistant strains (MDR-TB, XDR-TB)
- 1/3 world infected
KFS: History Demographics
• The condition is not incompatible with long life = persons 70.
• Heredity no influence, nor are
there any familial characteristics.
• Most remain asymptomatic throughout life, with occasional mild complaints such as headaches or
vague nonradicular weakness and numbness.
Dental Modifications: Types
-Coloring, or dyeing of teeth using different dyes
-Scraping patterns or filing to change the shape of the tooth.
-Dental inlays of various materials
- Extraction of healthy tooth for cultural reasons
>Jewel or Bead Inlays
> Modern Day Modifications
O.I. Differential Diagnosis: NAI Non-Accidental Injury
-Child Abuse
-Very hard to differentiate between the 2
-7% of kids with signs of abuse actually have a medical condition that would explain the injuries
Trepanation Healing: Long Term
-Extensive remodeling and rounding of margins
-Hole can even close or come
close to closing in some cases
- high survival rate= evidence of long term healing
a union of two or more digits that occurs in humans often as a hereditary disorder marked by the joining or webbing of two or more fingers or toes.
Meninges (meninx)
any of the 3 membranes that envelop the brain and spinal cord and include the arachnoid, dura mater, and pia mater
Spina bifida occultta
a mild often asymptomatic form of spina bifida in which there is no hernial protrusion of the meninges of the spinal cord
Dental Modifications: Ablation
Extracting teeth, when done as part of cultural modification, is generally associated with a rite of
passage, a mourning ritual, or a visible record of pain tolerance
L.O. Diff Diagnosis: Lepromatous Leprosy
Produces thickened, seamed lips and that looks like L.O.
Trepanation Overview
- Creation of the hole in the head
- performed by cutting out a peice of the skull with a sharp tool/scraping away
- done away from substantial muscle tissue like the nuchal crest
-Opening size varies, but reduction is caused by healing over time
-Survival rates increased for patients over time
L.O. Diff Diagnosis: Paget's Disease of the bone
-Chronic disorder that results in enlarged and deformed bone
-Rarely diagnosed in people under 40
-Targets spine, pelvis, skull(looks like L.O) and lower limb bones
-can happen in conjunction with L.O.
L.O. Diff Diagnosis: Hyperostosis Frontalis Interna
- a condition caused by unknown factors, characterized by benign overgrowth of the inner table of the frontal bone
-The skull thickening may be sessile/nodular looks like L.O.
Dental Mod: who does it?
- Dental Modifications are seen across theworld in both the bone record and in the living.
-People of high status that can afford to have expensive procedures done.
-Significant people in society who use a specific type of tooth modification to show their status or affiliation.
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