Evidence of trauma was investigated in a well-preserved skeletal sample from the Medieval Sudanese Nubian site of Kulubnarti. The skeletal materials derive from two temporally overlapping Christian cemeteries, dating from the sixth to circa the sixteenth century. The available sample consisted of the skeletons of 146 adults which were investigated for fractures of the long bones, crania and the hands and feet, as well as for dislocations and muscle pulls. Results showed a high incidence of long bone fractures, seen especially in the forearm, and involving 33.5 per cent of individuals. Many of these lesions indicated quite severe injury, and an unusually high number of affected individuals (27 per cent) showed multiple long bone involvement. Conversely, only one possible cranial fracture was apparent.Fractures were also found in 13 hand and seven foot elements. In addition, one hip dislocation and evidence of pulled tendons in 11 individuals were also observed. Compared to other similarly controlled samples, the Kulubnarti population stands out for its high prevalence of healed fractures, the high proportion of multiple involvement and the severity of numerous lesions. The forbiddingly harsh and uneven terrain of this region of Nubia was most likely a major in¯uence on the unusually high prevalence and pattern of traumatic lesions in this group.
The dental remains of ten adult chimpanzees from Gombe National Park, Tanzania, were examined for enamel attrition, caries, abscesses, periodontal disease, and tooth loss. Age was the underlying factor in the development of dental pathology, in that enamel wear was present to some extent in all ten but was uniformly severe only in the three for whom estimated age at death was 39-43 years. In turn, enamel wear appears to have been the direct cause of abscess development, periodontal disease, and tooth loss. Periodontal disease was commonly expressed as alveolar resorption, particularly around the premolars and molars. This involvement was variable in all except the two youngest. Some interesting wear patterns were evident in the form of deep grooves in the upper incisors and dramatic notching of the lower canines. These patterns, and enamel attrition in general, were attributed to normal mastication and to various stripping activities. Only one carious lesion was observed, in a male with an estimated age of 26 years. An accurate assessment of the actual prevalence of caries was obscured by enamel wear and tooth loss in the older individuals.
Due to its apparent absence in archaeologically derived skeletons, rheumatoid arthritis (RA) has generally been believed to be of fairly recent origin. A growing body of evidence now demonstrates that erosive lesions typical of RA are present in archaeological populations and that the antiquity of RA may be greater than previously expected. In support of this argument, a case of erosive arthritis is reported in a skeleton from Kulubnarti, Republic of the Sudan (c. 700-1450 A.D.). Lytic, erosive lesions and subchondral cysts are present bilaterally in the carpal and metacarpal joints of a female skeleton with an estimated age at death of 50+ years. These lesions are typical of those seen in clinically diagnosed rheumatoid patients. While their expression and distribution are highly suggestive of RA, interpretation must be made with due consideration for problems of differential diagnosis of this disease in archaeological material.
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