Autoimmune joint diseases in Late Medieval skeletal sample from Croatia

Abstract

Analysis of 25 skeletons from Late Medieval cemetery Uzdolje-Grablje near Knin, Croatia, revealed three cases of systematic pathological changes to joints. Observed pathological lesions were examined macroscopically and radiologically and compared to the available paleopathological standards in order to formulate a differential diagnosis. In all three cases observed changes were most consistent with autoimmune joint diseases including ankylosing spondylitis, juvenile idiopathic arthritis and psoriatic arthritis. Based on published clinical studies, we suggest that the high prevalence of autoimmune diseases in our skeletal sample stems from the genetic basis of the autoimmunity, and that three individuals describe here are possibly closely related.

Utilization of validated criteria for diagnostic assessment in nonsynchronous, allopatric populations: Role in archeologic diagnosis of rheumatoid arthritis and differentially distinguishing it from mimics

“…Erosions were predominantly subchondral rather than marginal in distribution in 28 cases (Arcini, 1992; Bennike, 1985; Blondiaux et al, 1997; Campillo, 1990; Ciranni et al, 2002; Clavel et al, 1999; Craps & Gowland, 2015; Fontecchio et al, 2007; Hacking et al, 1994; Hagihara et al, 2015; Inoue et al, 1999; Kacki, 2013; Kilgore, 1989; Klepinger, 1979; Mant, 2014; May, 1897; Mays et al, 2017; Mckinnon et al, 2013; Rogers et al, 1981), four of which had sclerotic erosional margins (Inoue et al, 1999; Kilgore, 1989; Mckinnon et al, 2013; Rogers et al, 1981) and four of which had surface calcific deposits (Ciranni et al, 2002; Kilgore, 1989; Mckinnon et al, 2013). Fusion of appendicular joints was present in 25 individuals (Arcini, 1992; Blondiaux et al, 1997; Campillo, 1990; Ciranni et al, 2002; Clavel et al, 1999; Hacking et al, 1994; Hagihara et al, 2015; Inoue et al, 1999; Isidro et al, 2015; Kilgore, 1989; Kim et al, 2011; Leden et al, 1988; Macke & Macke‐Ribet, 1994; May, 1897; Ruffer, 1918; Šikanjić & Vlak, 2010; Steinbock, 1976; Tesi et al, 2019; Thould & Thould, 1983). Osteophytes were prominent in six individuals (Arcini, 1992; Kilgore, 1989; Klepinger, 1979); reactive new bone formation around erosions (not including those with sclerotic margins on X‐ray) in two (Mant, 2014; Thould & Thould, 1983); periosteal reaction in four (Blondiaux et al, 1997; Hagihara et al, 2015; Leden et al, 1988); and enthesial reaction in two (Isidro et al,…”