Skeletal evidence of tuberculosis in a modern identified human skeletal collection (Certosa cemetery, Bologna, Italy)

Abstract

The diagnosis of tuberculosis (TB) in osteoarcheological series relies on the identification of osseous lesions caused by the disease. The study of identified skeletal collections provides the opportunity to investigate the distribution of skeletal lesions in relation to this disease. The aim of this study was to examine the skeletal evidence for TB in late adolescent and adult individuals from the identified human collection of the Certosa cemetery of Bologna (Italy, 19th-20th c.). The sample group consists of 244 individuals (138 males, 106 females) ranging from 17 to 88 years of age. The sample was divided into three groups on the basis of the recorded cause of death: TB (N = 64), pulmonary non-TB (N = 29), and other diseases (N = 151). Skeletal lesions reported to be related to TB were analyzed. The vertebral lesions were classified into three types: enlarged foramina (EnF, vascular foramina with diameter of 3-5 mm), erosions (ER), and other foramina (OtF, cavities of various shapes > 3 mm). A CT scan analysis was also performed on vertebral bodies. Some lesions were seldom present in our sample (e.g., tuberculous arthritis). OtF (23.7%) and subperiosteal new bone formation on ribs (54.2%) are significantly more frequent in the TB group with respect to the other groups. The CT scan analysis showed that the vertebrae of individuals who have died of TB may have internal cavities in the absence of external lesions. These traits represent useful elements in the paleopathological diagnosis of TB.

Rare manifestations of spinal tuberculosis in the Robert J. Terry Anatomical Skeletal Collection (National Museum of Natural History, Smithsonian Institution, Washington, DC, USA)

“…Erosive lesions occasionally accompanied by reactive new bone formation were detected on the left lamina and the adjoining part of the spinous process of T4 (Figure b), the right lateral aspect of the T7 and T12 bodies (Figure c), and the left lateral aspect of the L5 body (Figure d). Signs of hypervascularisation, indicative of early‐stage spinal TB (e.g., Baker, ; Mariotti et al, ; Ménard, ), were recorded on the anterior (T5–6; Figure a) and lateral (T10–12 and L1–5) aspects of the thoracic and lumbar bodies.…”

A probable case of subligamentous tuberculous spondylitis: The concealed body of theLate Modern Period(early 16th century to early 20th century),Franciscancrypt ofSt. AnthonyandSt. Eusebiuschurch,Lombardy,Italy

“…The size and shape of the spinal canal was analysed according to what is proposed by Coqueugniot et al (). The abnormal bone loss was scored according to the anthropological standards (Buikstra & Ubelaker, ) and a more in‐depth analysis of the lesions was possible thanks to the work of Mariotti et al ().…”

Posibles casos de tuberculosis y brucelosis en poblados argáricos de Galera (Granada)

“…Todas son formaciones de hueso nuevo en placa donde se observa claramente la separación entre la cortical del hueso y la aposición de hueso nuevo. En las últimas décadas, se han documentado formaciones de hueso nuevo en la superficie visceral de las costillas en colecciones de sujetos que padecieron tuberculosis (Kelley y Mariotti et al 2015). Hay que ser prudente a la hora de asociar estas lesiones costales con tuberculosis para poblaciones antiguas ya que de por sí no son determinantes (Mays et al 2002).…”

“…Esta lesión se ha considerado patognomónica de la tuberculosis en Paleopatología. Sin embargo, en numerosas publicaciones se plantea que las lesiones en la cara interna (visceral) de las costillas también podrían ser diagnosticadas como propias de la tuberculosis (Kelley y el Najjar 1980;Kelley y Micozzi 1984;Pfeiffer 1991;Roberts et al 1994;Matos y Santos 2006;Santos y Roberts 2006;Mariotti et al 2015).…”