An Early Case of Leprosy from Nubia

Moller-Christensen, V.; Hughes, Diane

doi:10.2307/2796351

Cited by 14 publications

(10 citation statements)

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“…In the limb extremities, resorptive changes commencing from the distal phalanges in the hands and from the metatarsophalangeal joints in the feet lead to diaphyseal remodelling with concentric or knifeedge patterns, and cupping deformity of the joints (Karat et al, 1968;Møller-Christensen, 1961;Wastie, 1975;Ortner, 2003). The gross appearance of the affected bone is one of thinning of the diaphysis caused by absorption of bone from the outer cortical surface.…”

Section: Leprosymentioning

confidence: 99%

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Periostitis and osteolysis in a medieval skeleton from South‐West Hungary: (Leprosy, treponematosis, tuberculosis or hypertrophic osteoarthropathy) A diagnostic challenge!

Christensen

Martı́nez-Lavı́n

Pineda³

2011

Intl J of Osteoarchaeology

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This paper uses macroscopic and radiological examinations to provide differential diagnoses of pathological lesions in the well-preserved skeleton of a young male from the medieval site of Zalavá r in South-West Hungary. Macroscopic inspection of the skeleton revealed conspicuous thickening of the tibiae and fibulae with 'tree bark' appearance of the cortex. Periosteal proliferations are also found on the calcanea and on the posterior part of the femora. The metatarsals showed bony proliferation and bone dissolution. No alteration of the axial skeleton or the skull was noted. Radiographs showed thickening of the cortex of tubular bones due to a multilayered type of periosteal apposition. The likelihood of these symptoms being the result of melorheostosis, hypervitaminosis A, fluorosis, thyroid acropachy, endosteal hyperostosis, tuberculosis (TB), hypertrophic osteoarthropathy (HOA), treponematosis and leprosy is reviewed. None completely explains the entire spectrum of pathological lesions in the current individual, but the individual may have suffered from two coexistent diseases. As a clinical entity, the changes in the metatarsals are compatible with leprosy, whereas the periosteal proliferations of the lower limbs point to a diagnosis of HOA as a secondary syndrome. Thus, a combination of leprosy and TB is suggested as a potential diagnosis. Although not definitive, our differential diagnosis was able to exclude a number of conditions producing periosteal apposition.

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Section: Leprosymentioning

confidence: 99%

“…Bilateral and symmetrical periostitis, especially in the distal half of the tibial and fibular shafts, is an almost constant feature of LL and near-LL forms. It is caused by neuropathy and secondary infection (Møller-Christensen, 1961;Andersen et al, 1994;Manchester, 2002).…”

Section: Leprosymentioning

confidence: 99%

Periostitis and osteolysis in a medieval skeleton from South‐West Hungary: (Leprosy, treponematosis, tuberculosis or hypertrophic osteoarthropathy) A diagnostic challenge!

Christensen

Martı́nez-Lavı́n

Pineda³

2011

Intl J of Osteoarchaeology

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“…The Ipswich Blackfriars cases each display rhinomaxillary changes indicative of long-standing lowresistance leprosy, and which indicate that the characteristic facial signs of leprosy would have been visible in life (Andersen & Manchester, 1992). For example, in burial 2624, the destruction of the anterior nasal spine and nasal crest would have resulted in the sunken nose which is a characteristic disfigurement of leprosy, and the lesions on the superior surface of the hard palate indicate chronic inflammation of the nasal cavity which in leprosy is normally accompanied by persistent purulent nasal discharge as well as swelling of nasal and palatine mucosa (Møller-Christensen, 1961;Aufderheide & Rodríguez-Martín, 1998: 144). The question naturally arises as to why these leprous individuals were buried in the Blackfriars, rather than at one of the three leprosaria which existed close to Ipswich in the late medieval period (Clay, 1909).…”

Section: Discussionmentioning

confidence: 99%

“…The alterations in the maxillo-facial skeleton and lower extremeties of burial 2624 are typical of leprosy (Møller-Christensen, 1961;Ortner, 2003: 263-71).…”

Section: Primary Dysplasia Of the Scapula Neckmentioning

confidence: 99%

A scapula deformity in two burials from medieval England

Mays

2008

Intl J of Osteoarchaeology

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A scapula malformation is described in two burials from the site of the late medieval Dominican friary at Ipswich, UK. The changes appear most consistent with primary scapular neck dysplasia. One of the burials also showed clear signs of leprosy. The burials are of lay benefactors of the friary. The Ipswich Dominican friary had no known function as a leprosy hospital. Finding of burials of lepers other than in burial grounds of leprosaria is highly unusual for medieval England. Scapular neck dysplasia has a strong genetic component in its aetiology. This, coupled with its rarity, suggests a close genetic link between the two burials. The findings suggest that in this case, family ties with the friary overrode the normal medieval custom of interring lepers in leprosy hospitals. This illustrates that even rare skeletal variants may convey useful biocultural information about past populations.

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“…The chronic indicators included: periostitis, tuberculosis, leprosy, treponema, degenerative spine changes, degenerative joint changes, Schmorl's nodes, and dental abscesses. These indicators were assessed using standard osteological methods (Møller- Christensen, 1961Christensen, , 1967Christensen, , 1978Bennike, 1985;Ortner, 2003;Boldsen, 2005Boldsen, , 2008Boldsen and Mollerup, 2006) and were all active at the time of death. It should be noted that there is some fluidity between these categories and the timeline of manifestation; therefore, these categories are not rigid but rather reflect the specific trends found in this Black Friars subsample.…”

Section: Methodsmentioning

confidence: 99%