Saturday, April 21, 2012

Differential Diagnosis of an Unusual Lower Leg Pathology in an Imperial Roman

A suite of skeletal pathologies was discovered on the remains of an older adult male from Imperial Rome. Individual F10A (Male, 50+) was buried in a niche in the mausoleum, suggesting higher social status than those in the necropolis and/or membership in a funeral guild. No grave goods were found associated with him, however.  Over 75% of the skeleton was recovered from the burial. F10A had a number of pathological conditions. He lost most of his teeth antemortem. Significant arthritic changes (porosity, lipping, osteophytes) were noted in his TMJ, shoulder, elbow, hip, and knee joints, as well as in the thoracic and lumbar spine. No rhinomaxillary changes were seen. The bones of his legs present pathologies inconsistent with solely age-related changes: The involved large tubs of caustic liquid, in which fullers would stamp cloth while barefoot–a task called the –which suggests a possible link between lower leg pathology and occupation. Yet mycetoma is difficult to diagnose in ancient remains. A possible case from 4th century AD Israel (Hershkovitz et al. 1992) was later found to have leprosy (Spigelman & Donoghue 2001). No such testing has been done on F10A to date. Osteological data, archaeological context, and geographic location suggest a diagnosis of mycetoma for individual F10A, but it is difficult to conclusively rule out leprosy and rheumatoid arthritis. Killgrove, K. 2010. . PhD dissertation, UNC Chapel Hill. Musco, S. et al. 2008. . 330:32-9. Ortner, D. 2003. . Academic Press. Plehn, A. 1928. Madurafuss. In Kolle & von Wasserman, eds., , pp. 113-132.