Robert Jurmain

Palaeoepidemiological Patterns of Trauma in a Medieval Nubian Skeletal Population

Evidence of trauma was investigated in a well-preserved skeletal sample from the Medieval Sudanese Nubian site of Kulubnarti. The skeletal materials derive from two temporally over-lapping Christian cemeteries, dating from the sixth to circa the sixteenth century. The available sample consisted of the skeletons of 146 adults which were investigated for fractures of the long bones, crania and the hands and feet, as well as for dislocations and muscle pulls. Results showed a high incidence of long bone fractures, seen especially in the forearm, and involving 33.5 per cent of individuals. Many of these lesions indicated quite severe injury, and an unusually high number of affected individuals (27 per cent) showed multiple long bone involvement. Conversely, only one possible cranial fracture was apparent. Fractures were also found in 13 hand and seven foot elements. In addition, one hip dislocation and evidence of pulled tendons in 11 individuals were also observed. Compared to other similarly controlled samples, the Kulubnarti population stands out for its high prevalence of healed fractures, the high proportion of multiple involvement and the severity of numerous lesions. The forbiddingly harsh and uneven terrain of this region of Nubia was most likely a major influence on the unusually high prevalence and pattern of traumatic lesions in this group.

Patterns of Cranial Trauma in a Prehistoric Population from Central California

Evidence of cranial trauma was investigated in a skeletal sample from the site CA-Ala-329 located on the eastern side of San Francisco Bay, Central California. The sample included 365 crania, including 134 adult males, 104 adult females, 22 adults of indeterminate sex and 105 subadults. Evidence of cranio-facial fracture was found in eight individuals, one of whom is an adolescent. Thus, the frequency in adult crania of traumatic injury is 7/260 (2.7 per cent). Of the seven individuals of known sex displaying such cranial trauma, all are male. The injuries are generally suggestive of some form of interpersonal aggression, with five healed vault fractures, one lesion with an embedded obsidian fragment (a probable projectile point) and two healed facial fractures. Further clear evidence of interpersonal aggression has been previously determined in this sample and has been reported at even higher levels elsewhere in California.

Paleoepidemiological Patterns of Interpersonal Aggression in a Prehistoric Central California Population From CA-ALA-329

Interpersonal aggression is assessed paleoepidemiologically in a large skeletal population from the CA-ALA-329 site located on the southeastern side of San Francisco Bay, California. This comprehensive analysis included all currently recognized skeletal criteria, including craniofacial fracture, projectile injury, forearm fracture, and perimortem bone modification. Craniofacial injury is moderately common, showing an adult prevalence of 9.0% with facial lesions accounting for >50% of involvement. Clinical studies suggest that such separate evaluation of facial involvement provides a useful perspective for understanding patterns of interpersonal aggression. In this group male facial involvement is significantly greater than in females, paralleling the pattern found widely in contemporary populations as well as in African apes. When compared to other North American skeletal samples the prevalence of adult cranial vault injury (3.3%) and especially projectile injury (4.4%) are quite high. However, well documented populations from southern California show markedly higher prevalence for both types of skeletal markers of aggression. Forearm fracture is also assessed using a rigorous radiographic methodology and results suggest that these injuries are not reliable indicators of interpersonal aggression. Lastly, perimortem bone modification was not observed in this population, although it has been recorded from other (older) sites nearby. This study provides an evaluation of multiple skeletal markers of interpersonal aggression in the largest sample from a single site yet reported in North America and, joined with consideration of cultural context, helps further illuminate both geographic and temporal patterns of interpersonal aggression in California.

Knee osteoarthritis has doubled in prevalence since the mid-20th century

Significance Knee osteoarthritis is a highly prevalent, disabling joint disease with causes that remain poorly understood but are commonly attributed to aging and obesity. To gain insight into the etiology of knee osteoarthritis, this study traces long-term trends in the disease in the United States using large skeletal samples spanning from prehistoric times to the present. We show that knee osteoarthritis long existed at low frequencies, but since the mid-20th century, the disease has doubled in prevalence. Our analyses contradict the view that the recent surge in knee osteoarthritis occurred simply because people live longer and are more commonly obese. Instead, our results highlight the need to study additional, likely preventable risk factors that have become ubiquitous within the last half-century. Knee osteoarthritis (OA) is believed to be highly prevalent today because of recent increases in life expectancy and body mass index (BMI), but this assumption has not been tested using long-term historical or evolutionary data. We analyzed long-term trends in knee OA prevalence in the United States using cadaver-derived skeletons of people aged ≥50 y whose BMI at death was documented and who lived during the early industrial era (1800s to early 1900s; n = 1,581) and the modern postindustrial era (late 1900s to early 2000s; n = 819). Knee OA among individuals estimated to be ≥50 y old was also assessed in archeologically derived skeletons of prehistoric hunter-gatherers and early farmers (6000–300 B.P.; n = 176). OA was diagnosed based on the presence of eburnation (polish from bone-on-bone contact). Overall, knee OA prevalence was found to be 16% among the postindustrial sample but only 6% and 8% among the early industrial and prehistoric samples, respectively. After controlling for age, BMI, and other variables, knee OA prevalence was 2.1-fold higher (95% confidence interval, 1.5–3.1) in the postindustrial sample than in the early industrial sample. Our results indicate that increases in longevity and BMI are insufficient to explain the approximate doubling of knee OA prevalence that has occurred in the United States since the mid-20th century. Knee OA is thus more preventable than is commonly assumed, but prevention will require research on additional independent risk factors that either arose or have become amplified in the postindustrial era.

Skeletal evidence of probable treponemal infection in free-ranging African apes.

The prevalence and patterning of inflammatory lesions of the skeleton were investigated in samples of chimpanzees (Pan troglodytes troglodytes) and gorillas (Gorilla gorilla gorilla) curated at the Powell-Cotton Museum, Birchington, UK. One hundred and two chimpanzees (42 adults and 60 subadults) and 126 gorillas (50 adults and 76 subadults) comprise the samples. Twenty per cent of chimpanzees and 14% of gorillas were affected with a disseminated inflammatory skeletal condition caused by infection. The lesions appear to have originated as localized patches of new bone deposition on the surface of long bones and to have progressed to infection of the bone cortex and marrow. Although female prevalence of involvement exceeds that of males in both species, the differences are not statistically significant. The age distribution of affected animals indicates that the disease began in some animals as early as 2 yr of age. Given the skeletal and demographic prevalence and patterning of the lesions as well as the ecology and behavior of these animals, the most likely diagnosis of the condition is a yaws-like treponemal infection.

Part one: Paleoepidemiology of degenerative knee disease

Abstract Degenerative knee disease is investigated in osteological samples from three human skeletal populations. The distribution of incidence shows Eskimos are the most frequently and severely affected group, and multivariate analysis further indicates localized age‐independent patterns of degenerative involvement within the knee. It is suggested that such variation results from functional stress within the knee joint. Various modes of cultural behavior may have caused biomechanical stress to differ significantly in prehistoric peoples, and variable functional factors most probably produced the observed differences in the distribution of degenerative disease.

In search of consensus: Terminology for entheseal changes (EC)

This article presents a consensus terminology for entheseal changes that was developed in English by an international team of scholars and then translated into French, Italian, Portuguese, Spanish and German. Use of a standard, neutral terminology to describe entheseal morphology will reduce misunderstandings between researchers, improve the reliability of comparisons between studies, and eliminate unwarranted etiological assumptions inherent in some of the descriptive terms presently used in the literature.