Possible rheumatoid arthritis found in the human skeleton collected from the tomb of Joseon Dynasty, Korea, dating back to the 1700s AD

Abstract

We report a possible rheumatoid arthritis (RA) case found in a Korean Joseon Dynasty (1392Dynasty ( -1910 tomb encapsulated by a lime-soil mixture barrier (LSMB). The tomb is thought to have been constructed during the 1700s AD (1760 AD by carbon dating). In our anthropological examination, joint destruction, erosion or fusion (signs of polyarthritis) were identified mainly in the peripheral skeleton. Especially in both sides of the wrist bones, severe destruction/joint fusion possibly caused by polyarthritis was observed. A similar polyarthritis pattern also was seen in the right foot bones, even though we failed to confirm this symmetry due to the missing left foot bones. Despite these findings, signs suggestive of polyarthritis are very rarely seen in axial bones, even though bony fusions are found in the atlanto-occipital joint or thoracic vertebrae (TV) 9-10. By the osteological signs observed in this case, the individual, a female, might have been suffering from a very late stage of RA and died in her 40s, even though other forms of chronic arthritis could not be ruled out completely. Though the current case could not provide evidence to decisively settle the debates on the antiquity of RA, our report could be a stepping stone for forthcoming studies on RA cases found in East Asian countries.

Stable isotope analysis of Joseon people skeletons from the cemeteries of Old Seoul City, the capital of Joseon Dynasty

“…Over the past several years, we have endeavored to build a human sample collection consisting of skeletons discovered in 16th-18th century Joseon cemeteries in Korea. In fact, our previous studies have yielded clarifying data on the health and disease statuses of pre-modern Joseon peoples [ 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. In the present study, to contribute to a better understanding of the food-intake patterns of pre-modern Joseon populations in Korean history, we tried to perform a stable isotope analysis on skeletons from the same Joseon collection.…”

Severe erosive polyarthritis in a human skeleton dated to the early modern period of Japan

“…Additionally, there have been only two reported cases of erosive polyarthritis from Japan (Inoue et al, 1999(Inoue et al, , 2005, and only one additional RA case from Korea (Kim et al, 2009). Paleopathological reports from Asia are many fewer than those from Europe or North America, and it is therefore important to report cases from Asia in the field.…”

“…There have been a number of reports in Japan of leprosy and osteoarthritis, which presented with polyarthritis (Suzuki, 1998;Moromizato et al, 2007;Suzuki et al, 2010). However, only two reports have been published concerning erosive polyarthritis, such as rheumatoid arthritis (RA) in Japan (Inoue et al, 1999(Inoue et al, , 2005, and only one report has been published for the rest of Asia (Kim et al, 2009). Additionally, such severe polyarthritis in an archaeological skeleton is rare globally.…”

The Diagnostic Implications of Two Cases of Known Rheumatoid Arthritis from the CAL Milano Cemetery Skeletal Collection

“…Compared to the SpA, the erosive and minimal new bone formation were always characteristics in favor of RA , particularly because the SpA present sacroiliitis and spinal fusion, contrary to RA . They also tend to be asymmetric in their peripheral joint involvement , and as previously mentioned, interphalangeal joint ankylosis is much more common. Erosive osteoarthritis, another lytic arthropathy affecting particularly the hands of middle‐aged women does not affect large joints .…”

“…The arthropathy is also characterized by a relative sparing of distal interphalangeal joints (DIP) (9,15,28) and of sacroiliac as well as spinal fusion (12,19,(29)(30)(31)(32)(33). RA can also cause erosions of the odontoid process leading to subluxations and dislocations (18,34,35), ulnar deviation of the bones of the hand (7,8,19,32,36), and possible « pencil-in-cup » deformities (31). Ankyloses are more common in the spondyloarthropathies (SpA) than in RA, although carpal and tarsal ankylosis are well known in RA and ankylosis of the PIP is possible (9,33,37,38).…”