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The studies of entheses in bioarchaeology attempted to reconstruct the habitual physical activities of past populations. However, the studies of microarchitecture of the underlying bone are still lacking despite well-known potential of bone internal microarchitecture to reflect mechanical loading. It is unknown whether different morphological expressions of entheseal changes (ECs) correlate with the microstructural characteristics of the underlining bone. This study analyzed bone microstructural characteristics at the entheses. Our focus was on examining the possible successive nature of the three-stage scale of entheseal macroscopic changes by comparing EC scores with the microarchitectural features at the attachment sites. The study was based on the hypothesis that mechanical loading influences the microarchitecture of the bone at the attachment site. The bone samples were taken from 24 adult male skeletons from medieval cemeteries in Serbia, with different macroscopic expression score of EC. We evaluated the macroscopic and microscopic appearance of four entheses of the lower limbs (origin of the soleus muscle and the insertions of the adductor magnus, gluteus maximus, and iliopsoas muscles). The specimens were scanned using microcomputed tomography (Scanco µCT 40). Our data showed a lack of consistent correlation between stages of the macroscopic scoring systems with microarchitecture at the entheses, only cortical thickness was significantly different between EC stages. Analyzing relationship between trabecular and cortical bone microstructure we found correlations between cortical and trabecular variables only in Stage C. Results of our study suggest that macroscopic EC might not represent distinct successive phases in bone adaptation to mechanical loading.

Porotic lesions of immature skeletons have been attracting scientific attention for more than a century. These changes have been documented worldwide and are considered to be one of the indicators of health and/or nutritional status of past human populations. These lesions have frequently been referred to as a nutritional stress indicator, a manifestation of iron-deficiency anaemia, and a condition caused by chronic infections. In this study, 327 immature skeletons from the medieval graveyard of Stara Torina (Serbia) were examined for macroscopic signs of four types of porotic lesions: cribra orbitalia, femoral cribra, humeral cribra, and porotic hyperostosis. Femoral cribra was observed in 83.25% of femora, humeral cribra in 58.46% of cases, cribra orbitalia in 46.12% of orbits, while porotic hyperostosis was recorded in only 2.94% of skulls. The majority of skeletons affected by cribra presented symmetrical lesions. Association between all types of cribra was recorded in 33.33% of skeletons. Historical data supported the hypothesis that the investigated population was exposed to frequent infections, especially parasitic ones, which led to the development of porotic bone lesions via several mechanisms: parasite-induced blood loss and diarrhoea (both iron and magnesium malabsorption) or anaemia as a hepcidin-mediated body adaptive response to infection.

Children are often under-represented in excavated populations due to the poor survival of their bones. Using a group of medieval burials from Serbia, our researchers examine the differential survival of children and of different parts of the body within the same terrain, and rightly urge us to take these factors into consideration before attempting demographic, ritual or social interpretations.

In order to establish a reliable age indicator in the period when all other epiphyseal age indicators have already been inactivated, medial clavicle as the bone with the longest period of growth became the object of various investigations. However, the lack of population-specific method often made it unreliable in some regions. The current study involved a Balkan population and it was designed in order to examine whether morphological, radiological, and histological analyses of medial clavicles could be applied with success in age assessment of individuals beyond their twenties in anthropological and forensic practice. The medial clavicular specimens were collected from contemporary Serbian population, autopsied in the period from 1998 to 2001, encompassing 67 individuals (42 males and 25 females) with the age range from 20 to 90 years. The conducted analyses of morphological features identified the epiphyseal union timing, signs of lipping in the region of the notch for the first rib as well as exostoses and bone overgrowths of the articular surface margin as age-dependent attributes. Trabecular bone volume fraction and minimum trabecular width were also highlighted as age-distinctive microscopic features. Sex difference was ascertainable in epiphyseal union timing, morphology of the notch for the first rib, margin of the articular surface, and basic morphology of articular surface as well as in two microscopic characteristics: trabecular bone volume fraction and minimum trabecular width. The study managed to identify several age- and sex-related features that could be applied as additional guidance for age estimation in Serbian population.

The present study analysed macromorphological characteristics of the muscle attachment sites of lower limbs, hypothesising that everyday physical activities influence the macromorphology of the bone at the entheses. Our specific goals were to investigate how different habitual activities influence the morphology of the muscle attachment sites of lower limbs in two different medieval populations from Serbia: agricultural versus horse-riding populations. The skeletal material used in this study comprised two different populations: a Medieval Avarian population of horse riders from two necropolises (Pionirska Ulica and Čik, in Bečeј) and an agricultural population represented by two sites-Medieval Vinča near Belgrade and Sirmium (Sremska Mitrovica), Site No. 85. The macromorphological analysis of the entheseal changes (ECs) encompassed 10 entheses of the lower limbs. Morphological appearance of entheses was evaluated using the visual reference system proposed by Villotte.The results revealed an age dependence in one muscle of the lower limbs (Musculus gluteus maximus) among the agricultural population, suggested by more pronounced ECs in the older age categories. Among the Avarian population, more pronounced EC scores were recorded in the older age groups for the attachment site of Musculus soleus, while in the case of the iliopsoas muscle, ECs were more common in younger ages. The results revealed more pronounced EC scores in males in both populations.Between the riders and agricultural populations, results indicated that only the adductor muscles which are specific for horse riders were singled out, showing a more pronounced ECs in the horse riders' population.Results of our study showed that the level of physical activity mostly increased with age. In both investigated populations, EC scores were more pronounced in males compared with females. Moreover, we noted that the evaluation of entheses of adductor muscles could provide the most reliable criteria for the identification of riders among the general population.

The ossification patterns of medial clavicle and the first costal cartilage represent interesting features of the same anatomical region which are accessible for conventional radiographic and computed tomography (CT) examinations in the same field of view. This study encompassed Serbian population and was carried out to examine whether CT analyses of medial clavicle and the first costal cartilage could be successfully applied, either individually or conjointly, in the age assessment. The study was based on CT examinations of thoracic region of 154 patients, aged between 15 and 35 years. Besides radiodensity and stages of epiphyseal cartilage ossification of medial clavicle, the study detected other features that expressed significant correlation with age, such as calculated anterior to posterior cortical thickness ratio, medullar canal diameter, and clavicular shaft diameter. However, although calculated ossified and calcified linear projections' (OCP) stages correlated to age, the distinction between stages was not satisfying. The interaction between the ossification status of medial clavicle and OCP was not significantly influenced by age. The results of our study outlined interesting new age predictors with mutual relationship: acquired radio density of the sternal epiphyseal-metaphyseal region and radio density of the first costal cartilage. Intersex variability was observed in several age-related features: calculated anterior to posterior cortical thickness ratio, diameter of medullar canal, and diameter of the clavicular shaft. Altogether, our study identified several radiological features of the first costal cartilage and medial clavicle that correlated with age and which could be applied as additional guidance for age estimation in each specific case.

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