Humerus Varus in a Subadult Skeleton from the Medieval Graveyard of La Madeleine (Orléans, France)

Abstract

The skeleton of a subadult individual from the medieval graveyard of La Madeleine (Orléans, France) exhibits varus deformity of its right humerus. The affected bone is shortened, the diaphysis is angulated and the head is grossly deformed. The skeleton is otherwise normal. Several diagnoses are debated, including mucopolysaccharidoses, thalassemia, infection and trauma, the latter being preferred. The severity of the bone changes suggests that the growth disturbance occurred early in the life of the individual. We therefore suppose that the causative trauma occurred at the time of birth or during the early postnatal period.

Paleopathological Study of Dwarfism-Related Skeletal Dysplasia in a Late Joseon Dynasty (South Korean) Population

“…In this study, we carefully examined specimen EP-III-4-No.107 through macroscopic and radiographic evaluation. The deformities of the humeri and glenohumeral joints are typical features of humerus varus deformity (HVD) [ 11 – 12 ]. Furthermore, the skeletal dysplasia in this case occurred in the epiphyseal plates of the clavicles, the scapulae, the radius and the ulna.…”

“…In this study, the abnormal morphology of the humerus of individual EP-III-4-No.107 was closely aligned with typical clinical cases of proximal humerus varus, as it displayed nearly complete failure in epiphyseal development. HVD can be an important clue to the diagnosis of ancient diseases, in spite of being associated with a wide range of etiologies [ 12 , 23 , 37 ]. HVD occurs in patients with thalassemia-related hemolytic anemia, which varies in prevalence from 14% to approximately 50% [ 11 , 23 , 38 ].…”

“…Also, thalassemia causes marked thickening of the cranial vault, with the resultant “hair-on-end” appearance, porotic hyperostosis, and enlargement of the marrow space in the long bones [ 42 – 43 ]. According to genetic studies, the most common form of thalassemia (ß-thalassemia) mainly occurs predominantly in people from the central and eastern Mediterranean regions [ 12 , 40 ], even if global migration has led to its spread around the world [ 42 ]. Currently, in South Korea, the carrier frequency of ß-thalassemia is reported to be only around 0.1% [ 44 ]; furthermore, the Korean climate is unsuitable for the maintenance of thalassemia.…”

Thalassemia major in a 49‐year‐old Thai female: Gross and X‐ray examination of dry bone

“…However, other genetic disorders (e.g., mucopolysaccharidosis; Ogden et al, 1976), infection (Kacki et al, 2011;Peters et al, 1992), metabolic diseases (e.g., rickets and osteomalacia; Ogden et al, 1976), and trauma (Ellefsen et al, 1994;Kacki et al, 2011;Makela et al, 1988) can also lead to this condition.…”

Glenoid retroversion: The palaeopathological perspective

“…They are only discussed as a differential diagnosis of other pathological conditions of the scapulohumeral joint, as in Mays (2009) for cases of probable primary dysplasia. In contexts of thalassemia, infection or trauma, attention usually focuses on humeral lesions, while glenoid lesions are seen only as secondary osteoarthritis (Hershkovitz et al, 1991;Pálfi, 1997, p. 40;Molto, 2000;Kacki et al, 2013). Similarly, in rotator cuff disease (Roberts et al, 2007), there is no reference to glenoid version, although it probably has a predisposing role in the distribution of muscle stress, with retroversion related more often to anterior cuff tears (Tétreault et al, 2004).…”