A skeletal case of hypertrophic osteoarthropathy from the Canary Islands dating from 1000 BP.

A left tibia, the distal right tibia, and the proximal four fifths of the right ulna and radius, probably belonging to an adult prehispanic man (antiquity of ≈1000 years BP) were found among commingled bone remains in a collective burial cave of the island of El Hierro, in the Canary Archipelago. All four bones show an intense periosteal bone formation, encrusting the preserved cortical bone of the diaphyses. Differential diagnosis include melorheostosis, syphilis, and leprosy, although the most likely diagnosis is hypertrophic osteoarthropathy, which is usually associated with lung neoplasm or non-malignant diseases leading to chronic hypoxemia. The marked bone proliferation, possibly due to a chronic condition, suggests that possibly the underlying illness was a non-malignant one.

Relationships between bending and torsional strengths of the tibia and simple anthropometric variables among the prehispanic population of El Hierro (Canary Islands)

Assessment of skeletal robusticity is an important tool for the archaeologist and anthropologist, since it may be related to the intensity and type of activity performed by ancient population groups. Development of computed tomography (CT) allows determination of biomechanical properties of long bones. However, CT technology may not be easily available and is a relatively expensive procedure. Therefore, it is pertinent to estimate whether any of the parameters which can be easily measured in bare bones by simple anthropometry are useful to assess the torsional strength and bending strength of these bones. We included twenty one well preserved tibiae corresponding to prehispanic adult individuals (13 men) of El Hierro. These bones were anthropometrically measured following classical methods, and also subjected to CT analysis, and further calculation of minimum and maximum second moments and polar second moment of area, both at midshaft and at the nutrient foramen levels, using the software (www.hopkinsmedicine.org/FAE/mmacro.htm). The diaphyseal robusticity index showed a close relationship with minimum second moment of area at the nutrient foramen (r=0.824, p<0.001) and polar second moment of area at the nutrient foramen (r=0.824, p<0.001), whereas correlations with the epiphyseal robusticity index were weaker (r=0.628, p=0.005, and r=0.618, p=0.007, respectively). The variable which allows the best estimation of the torsional strength is the perimeter at the nutrient foramen, by the formula Polar second moment of area (in mm3) = -700.30 + 11.77 * perimeter at the nutrient foramen (in mm) for the whole population (standard error of the estimation=56.91; absolute range from-114.26 to 140.29), or Polar second moment of area (in mm3) = -897.93 + 13.74 * perimeter at the nutrient foramen (in mm) when only men were analyzed, with a standard error of the estimation of 32.17 (absolute range= from -44.53 to 50.32 mm3)

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Reproducibility measuring the angle of proximal junctional kyphosis using the first or the second vertebra above the upper instrumented vertebrae in patients surgically treated for scoliosis.

STUDY DESIGN: A historical cohort study. OBJECTIVE: To evaluate the reproducibility of this measure in proximal junctional kyphosis (PJK) and to determine whether differences exist between first and second vertebrae angles. SUMMARY OF BACKGROUND DATA: There are no previous studies on the precision and accuracy of selecting the first or the second vertebra above the upper instrumented vertebrae to determine the degree of spinal angulation after surgery.In several studies, the first or the second vertebrae above the upper instrumented vertebrae (UIV) have been selected to measure the angle of PJK in a surgical setting. However, to our knowledge, no studies have addressed the reliability of this measure.We aimed to evaluate the reproducibility of this measure in PJK and to determine whether differences exist between first and second vertebrae angles. METHODS: A total of 38 randomly ordered radiologic digital images were obtained at 2 different times from 19 consecutive patients (aged 18.4 +/- 6.0 years at intervention) surgically treated for scoliosis. Using these images in a blinded manner, 2 surgeons independently measured angles at both the first and second vertebrae above the UIV. The measures were repeated in different periods to test intra- and intersurgeon concordances. RESULTS: For 152 measures, intrasurgeon concordance correlation coefficients ranged from 0.78 to 0.92 (high to very high reproducibility) and comparative intersurgeon concordance correlation coefficients ranged from 0.55 to 0.80 (moderate to high reproducibility). No differences were found between the first and the second vertebrae angles. CONCLUSION: Good reproducibility and agreement using the first and second vertebrae above the UIV to measure the angle of PJK was found in this study.