A truncated temporal styloid process from the Jordanian Ottoman Period: Developmental variant or fracture?

Styloid process (SP) development and its role in an individual's lived experience plays a negligible role in paleopathological research, although a handful of possible Eagle's syndrome cases have been reported. Here, the development of the stylohyoid chain and the medical research of SP variants are reviewed to inform the differential diagnosis of a probable SP fracture in a young adult male associated with the Ottoman Period (13-19thC) in Jordan. The fracture surface of the right SP is smooth rather than irregular, the coloration is uniform with the surrounding cortical bone staining, and no new bone formation is visible. All features are consistent with a perimortem injury. An unossified stylohyal is a differential diagnosis, while the left elongated SP suggests a predisposition to intrinsic injury. The implications of SP fractures are considered.

Inherited knee disorders in the Medici family.

Reconstructing a medical condition which was existent centuries ago is limited by the lack of contemporaneous evidence-based descriptions in the accounts given by physicians and other observers. Despite these limitations modern paleopathological evidence, supplemented by techniques of historical investigation, have led to the conclusion that males in the Medici family typically suffered from a complex clinical entity with a triple pathology of stenotic spinal ankylosis, recurrent peripheral joint disease and erythematous skin disease; the Medici Syndrome. Examination of the knee joint is illustrative of recurrent joint disease both in the primary and secondary lines of the family. Pictorial and sculptural representations, if used cautiously, can assist in this retrospective process. The six cases presented here illustrate the involvement of the knee joint where the joint destruction ultimately led to an ankylosis.

A possible case of Eagle's syndrome from an Italian ossuary (Chiavari, GE).

Eagle's syndrome is a rare condition associated with the temporal styloid process hypertrophy (Eagle, 1937). It is in most cases asymptomatic, but may be accompanied by dysphagia, pharyngeal or head and neck pain due to neurovascular structure compression. The current study aims to present and discuss the etiology of a possible case of Eagle's syndrome from an Italian ossuary. Skull OC 002/08 shows a unilateral hypertrophic styloid process (48 mm long; 5-7 mm thick). Areas of remodel-ed periosteal swelling are visible at the stylohyoid and stylopharyngeus muscles' insertion, along with evidence of healed trauma to both nasal bones and a depressed fracture on the upper left portion of the frontal. Several factors have been proposed as possible causes of styloid elongation, including anatomical variation, aging and trauma. Evidence of unilateral styloid hypertrophy in association with healed cranial trauma in OC 002/08 suggests a traumatic etiology for the condition.

Adam Politzer (1835-1920) and the description of otosclerosis.

In 1893, Adam Politzer was the first to describe otosclerosis as a specific disease fixating the stapes. The aim of this study is to follow Politzer's research to understand how he finally explained the mechanism responsible for the fixation of the stapes. Politzer conducted his preliminary research from 1862 to 1893. From the concept of a dry catarrh of the middle ear, the fixation of the stapes became progressively associated with a specific ossification in and around the footplate. Politzer presented his first results in 1893. He completed his research by concluding in 1901 that otosclerosis had become an independent disease and should have the right to its own chapter in otologic books. He selected the word otosclerosis to describe this new pathologic entity.

Is osteoarthritis a systemic disorder of bone?

OBJECTIVE: To describe the osteologic findings associated with osteoarthritis (OA) of a variety of joints. METHODS: We performed visual examination of 563 skeletons of which >/=80% of the skeleton was available, from an archaeologic site in England. The surfaces and margins of several different joints (shoulders, elbows, wrists, hips, hands, knees, and ankles) were studied for evidence of eburnation and osteophytes, respectively, and the entire skeleton was examined for evidence of generalized enthesophyte formation. Associations between changes in different joint sites and between enthesophyte formation and evidence of OA were sought. RESULTS: Eburnation and osteophyte formation at the hand, hip, and knee were strongly associated with eburnation and osteophytes at other joint sites not commonly thought to be prone to OA, including the elbow and wrist. Only the ankle was rarely involved. There was also a strong relationship between both bone eburnation and osteophytes and generalized enthesophyte formation. These findings remained statistically significant after adjustment for the age, sex, and historical period of the skeletons. CONCLUSION: Our findings indicate that skeletal OA is more widespread in the body than is apparent from clinical studies and are consistent with other data suggesting that OA is a disease that is primarily dependent on systemic predisposition to a particular type of bone response to mechanical stress.

[Multiple pathology in a Merowingian individual of a graveyard near Insheim (Rhineland-Pfalz)]. / Multiple Pathologien an einem merowingischen Individuum aus einem Reihengräberfeld bei Insheim (Rheinland-Pfalz).

The following case report describes in detail a 57 years old (+/- 5 years) male individual from a Franconian graveyard in Insheim, Province of Rhineland-Palatinate, dating to between the 6th and 7th century A.D. The individual displays a number of unusual pathologies. The atlas shows a complete aplasia of the posterior arch, probably resulting in a torticollis. The changed static induced a massive spondylar-arthrotic degeneration of the cervical spine on the right-lateral portion. On the fronto-parietal section two fractures are visible which were caused by a sharp and violent force. The area in question measures 7 by 10 cm. It has healed in a dislocated position. The second location displays marks of a 6 cm long sword-cut which did strike the skull obtusely on the left parietal. In addition to the above the skull displays on its right side a great number of small circular hole defects which also appear on ribs, vertebrae, clavicula and the mandible. They present the typical picture of a plasmocytoma. As an expression of a secondary hyperparathyreoidism one can recognize ossifications of soft tissue on the calcaneus, tibia, fibula and patella as well as intravital loss of mandibular dentition. It is quite remarkable that the individual reached a relative old age despite of his numerous and serious physical encroachments due to the apparent and obvious intentions of his aggressive contemporaries to kill him.

[Bone lithiasis in the period of the Enlightenment: D.F.J.B. Trehet]. / La litiasis ósea en el periodo de la ilustración: D.F.J.B. Trehet.

OBJECTIVE: To briefly describe the life and works of D.F.J.B. Trehet, a physician of the city of Rouen (France), who was the first to describe the "osseous points" in a renal calculus. Trèhet has not been recognized or referenced for this original observation in the urological publications. METHODS: Trehet lived in the period of the Enlightenment and endured the upheavals of the French Revolution. Data gleaned from several sources have permitted and elaborate description of this French physician from both the social and professional perspectives. RESULTS: After completing his studies at the Hôtel Dieu in Rouen, D.F.J.B. Trehet pursued his education at the School of Health in Paris. He read his doctorate's thesis at the Paris School of Medicine in 1803 and published his observation of a renal calculus "with osseous points" in 1812. Other studies by D.F.J.B. Trehet were also published in Le Journal de Médecine, Chirurgie et Pharmacie. CONCLUSIONS: D.F.J.B. Trehet should be recognized as the first to describe an osseous renal calculus.

Did ossification of the posterior longitudinal ligament of the spine evolve in the modern period? A paleopathologic study of ancient human skeletons in Japan.

OBJECTIVE: To investigate the historical origins of ligamentous ossifications of the spine in Japan. METHODS: We studied skeletons of Jomonese of the period 5000-2300 years BP, of Japanese of the 17th-19th century Edo Period, and of Ainu of the 18th-20th century in Japan with special emphasis on spinal ligament ossifications as in the posterior longitudinal ligament. A comparison to our previous study on ancient Chinese skeletons was done. RESULTS: Cervical ossification of the posterior longitudinal ligament (OPLL) was the only ossification that increased significantly in prevalence in people of the near-modern period in comparison to the Neolithic gathering-hunting people. CONCLUSION: Socioeconomic changes from a subsistence gathering-hunting economy to the near-modern livelihood depending on rice-eating and a diet high in vegetable protein are speculated to be responsible for the prevalence increase of cervical OPLL.

Rare temporal bone pathology of the Singa calvaria from Sudan.

Evidence has recently accumulated that the Singa calvaria from Sudan probably dates from Oxygen Isotope Stage 6 (>130 ka). Morphological studies have indicated a mixture of archaic and more modern human traits, but such analyses are complicated by the possibility that the vault is pathologically deformed, although the exact etiology has not been established. Now computed tomography (CT) has revealed that the right temporal bone lacks the structures of the bony labyrinth. The most likely cause of this rare pathological condition appears to be labyrinthine ossification, in which newly deposited bone obliterates the inner ear spaces following an infectious disease or occlusion of the labyrinthine blood supply. A possible cause of vascular compromise could have been the presence of an expanding acoustic neuroma in the internal acoustic meatus, which is suggested by a significantly wider right meatus compared with the left side. Interestingly, labyrinthine ossification is also consistent with the controversial diagnosis that an anemia caused the characteristic diploic widening at the parietal bosses, because prime etiological factors of ossification are among the common complications of some of these blood diseases. CT examination of the vault and a review of the literature suggest that a blood disorder may well have caused the unusual parietal morphology. Given the nature of these pathological conditions, the Singa individual must have experienced a period of considerable disability. The morphological evidence from the normal bony labyrinth on the left side and from the CT evaluation of the vault is consistent with the interpretation of Singa as a late archaic hominid or an early representative of Homo sapiens drawn from a population which might be directly ancestral to modern humans.

The styloid-stylohyoid syndrome.

The complexities of the styloid-stylohyoid syndrome are examined from the historical, anatomical, radiographic, clinical and treatment aspects. Although approximately 4% of the population is afflicted with this anomalous growth, the syndrome is not usually seen clinically until after the age of 30. There appears to be little correlation between the size and extent of the anomaly and the predictability of patients having symptoms related to the anomaly. The awareness of the anomaly and the syndrome can lead to a proper diagnosis and the appropriate treatment for the patient who has been labeled by the dental community or medical community, or both, as psychoneurotic.