A case of secondary hypertrophic osteoarthropathy from medieval Tuscany (central Italy, 10th-12th centuries CE).

OBJECTIVES: This study aims to provide a detailed evaluation of a case of secondary hypertrophic osteoarthropathy (HOA) and to explore insights into the presence and consequences of disease in medieval rural Italy. MATERIALS: The skeleton of a male (US 4405) with an estimated age at death of 51-69 years excavated from the medieval rural site of Pieve di Pava (Siena, Italy). METHODS: Macroscopic and radiological (x-ray, CT) analyses were performed. RESULTS: Symmetrical extensive periosteal new bone formation on the diaphyseal and metaphyseal regions of this individual's long bones; the lower limbs were more extensively and severely affected than the upper limbs and the distal segments were more severely altered in comparison to the proximal ones. CONCLUSIONS: The macroscopic and radiological features are highly consistent with a diagnosis of secondary HOA. SIGNIFICANCE: The excellent state of preservation allowed the evaluation of rarely noted skeletal manifestations of HOA and provided insight into aspects of rural life in medieval Italy. LIMITATIONS: Molecular analysis was not successful in sequencing the aDNA of tuberculosis, therefore the underlying primary cause of secondary HOA, whether pulmonary or extrapulmonary, remains obscure in this case. SUGGESTION FOR THE FUTURE RESEARCH: It is advisable to regularly revisit the data available from osteoarchaeological collections in order to identify further cases of HOA, along with to further investigate the known cases to search for the underlying primary disease.

Contextualizing bilateral asymmetry and gender: A multivariate approach to femoral cross-sectional geometry at rural Medieval Pieve di Pava, Italy.

OBJECTIVES: Our objective was to identify the relationship between biocultural factors of sex-gender and age and patterns of femoral cross-sectional geometry with historical evidence about labor and activity from an archeological skeletal sample excavated from the rural Medieval site Pieve di Pava. MATERIALS AND METHODS: The study site, Pieve di Pava, was a rural parish cemetery in Tuscany with osteoarcheological remains from the 7th to 12th centuries. Cross-sectional geometric analysis of femora from 110 individuals dated to the 10th-12th centuries were used to examine trends in bone quantity, shape, and bending strength between age and sex groups, as well as in clusters identified through Hierarchical Cluster Analysis (HCA). RESULTS: Overall, our study sample showed remarkable heterogeneity and our cluster analysis revealed a complex underlying structure, indicating that divisions of labor did not follow a strict gender binary in our sample. We found high levels of bilateral asymmetry in our sample in multiple cross-sectional areas for a significant proportion of the population. We found minimal differences between age groups or sex. DISCUSSION: Our results suggest that males and females had varied experiences of labor and work during their lives that did not reflect the strict binary gender roles sometimes documented for medieval Europe. One important axis of difference is the direction and magnitude of bilateral asymmetry observed in our femur sample, which is associated with divergent trends in section moduli and bone area measures.

Exploring activity-induced dental modifications in medieval Pieve di Pava (central Italy, 10th-12th centuries AD).

OBJECTIVE: This study aims to investigate the following aspects: i) presence of activity-induced dental modifications (AIDMs) in a medieval population from Pieve di Pava (Siena, central Italy); ii) sex-specific and age-specific distribution of AIDMs in the sample; iii) potential correlations between AIDMs and the tradi tional activities and cultural habits of rural communities in medieval Italy. DESIGN: The permanent teeth of 204 individuals buried at Pieve di Pava (10th-12th centuries AD) were systematically examined in order to assess the distribution of five types of AIDM, i.e. lingual surface attrition of the maxillary anterior teeth (LSAMAT), excessive occlusal load, grooving, notching, and chipping. RESULTS: Prevalence rates of LSAMAT, excessive occlusal load and grooving were low, whereas higher frequencies were recorded for the other types of AIDMs. Prevalence was higher in the male subsample for all the modifications recorded. Overall, the frequencies of AIDMs increased with age. CONCLUSIONS: The very low prevalence of LSAMAT was thought to be connected to leatherworking in the sample under study, while excessive occlusal load was interpreted as evidence that hard materials requiring preliminary chewing and softening were not regularly processed with teeth. The unique case of interproximal grooving in an old male individual may reflect the use of a toothpick for therapeutic purpose. Conversely, the very high prevalence of notching and chipping was taken as indicative of the processing of wool fibers. The sex-specific distribution of these AIDMs suggests that males performed activities involving the use of teeth more frequently than females.

Maxillary sinusitis as a respiratory health indicator: a bioarchaeological investigation into medieval central Italy.

OBJECTIVE: This study aims to assess chronic maxillary sinusitis in an osteoarchaeological sample from the medieval rural site of Pieve di Pava (central Italy), to investigate triggers responsible for sinus inflammation, and to compare prevalence rates with coeval European rural sites. MATERIALS: The analysis focused on 145 10th-12th-century adults with at least one preserved maxillary sinus. METHODS: Sinusitis-related lesions were observed macroscopically and microscopically. Alveolar pathologies of the maxillary posterior dentition were recorded to investigate the impact of odontogenic sinusitis. RESULTS: Maxillary sinusitis was observed in 23.4% of the individuals (n = 34), with similar frequencies in both sexes and bilateral sinusitis appearing more frequently than unilateral sinusitis. An association of alveolar lesions with sinusitis was found in 38.2% of cases. CONCLUSIONS: Compared to coeval rural sites in Northern Europe, Pieve di Pava shows the lowest prevalence of maxillary sinusitis, likely reflecting a greater amount of time spent outdoors. Despite the small size of the sample, odontogenic sinusitis cannot be ruled out. SIGNIFICANCE: This is the first Italian study to investigate maxillary sinusitis and to focus on the Mediterranean area, contributing to the understanding of this condition as a health indicator in ancient populations. LIMITATIONS: Research limitations include preservation issues affecting the number of observable sinuses, the non-homogenous age distribution of the sample, and the impact of inclusion and methodological criteria on the comparability of results. SUGGESTIONS FOR FURTHER RESEARCH: Further investigations into odontogenic sinusitis and the microscopic examination of dental calculus may provide new data on the pathogenesis of sinusitis.

The privileged burial of the Pava Pieve (Siena, 8th Century AD).

RATIONALE: The 6(th) archaeological excavation campaign performed at the 'Pieve di Pava' (San Giovanni d'Asso, Siena, Italy) unearthed a privileged stone burial of a single individual (US 2378), covered by a monolithic slab and placed in front of an altar. The skeletal remains of a young male (18-20 years old), not in anatomical connection, were found at the bottom floor of a tomb (160 cm long, 40 cm large and over 70 cm deep). METHODS: A multidisciplinary study has been carried out concerning that privileged bone burial. The study combines paleopathology studies, stable isotope palaeodietary reconstruction, radiocarbon dating and archaeological analyses. RESULTS: (14) C dating of the skeleton revealed a date between 650 and 688 AD. Stable isotope analysis (δ(18) O, δ(13) C, δ(15) N) attested that he was probably a member of the local population, whose diet was rather rich in animal proteins. The paleopathological study diagnosed a case of acromesomelic dysplasia, a congenital anomaly with disproportion of the limbs. Archaeological evidence regarding the circular delimitation of the bones suggested that the skeleton was a secondary deposition, transported to the church in a sack. CONCLUSIONS: We argue that the relic was used for the re-consecration of the church, following the restoration work in the 8(th) century. We conclude that the skeleton belonged to an eminent personage (e.g., either the member of a local elite family or a saint).