Diseased Bone
Friday, January 15th, 2010Paget ’s disease
A major difficulty when diagnosing pathological disease in archaeological skeletal remains is that many conditions may only affect the soft tissues of the body, such as the skin or organs. This may result in the death of a person before bone changes took place, leaving no visible traces on the skeleton to be observed. Some diseases, however, may directly affect the bones. The way that bone responds and the distribution pattern of changes throughout the skeleton, enable certain pathologies suffered in life to be identified.
One such pathology occasionally encountered in the osteological analysis of archaeological human bone is Paget’s disease. During life, the human skeleton constantly remodels, repairs and grows. Paget’s disease disrupts this normal routine and results in an increased bone turnover. This can affect single or multiple bones and involve the entire skeleton, resulting in severe deformity and enlargement of affected areas. The skull, spine, sacrum and upper legs are the most commonly involved.
This rare condition was first described by James Paget in 1877. Today the exact causes remain unknown and multiple origins are thought likely. In modern cases, the disease is more common amongst males than females and tends to affect older individuals.
The osteological analysis of post-medieval population from Bow Baptist Church, London by MoLA revealed one individual who displayed bone changes consistent with a diagnosis of Paget’s disease.
An older male aged 46 years or over displayed thickening of the cranial bones with new bone formed to the internal and outer surfaces that was porous and pumice stone like. Examination of radiographs revealed enlargement of the bone cortex with areas that displayed a ‘cotton wool’ like appearance.
The vertebral bodies also showed enlargement and this was more apparent in the lower lumbar regions of the spine. Radiographs showed sclerotic areas (thickening) at the margins of the vertebral centra and areas of porosity to the internal trabecular structures. This gave a ‘picture frame’ appearance in radiographs. The disease had also resulted in deformity and enlargement to the clavicles (collar bone), scapula (shoulder) upper legs and pelvis.
Pathological fractures are a common feature of this disease due to weakening of the bone structures that may cause bowing of the limbs. This individual had suffered compression fractures to several vertebrae. This had also resulted in degenerative joint disease and osteoarthritis throughout the spine. Osteoarthritis was also recorded in the hands and shoulder joints.
This individual may have been unaware that he had such a disease during life as many cases are asymptomatic. However, some people can suffer bone pain, headaches and hearing loss.
For more information see:
Brickley, M, and Ives, R, 2008 The bioarchaeology of metabolic disease, Oxford
Ortner DJ, 2003, Identification of pathological conditions in human skeletal remains. London
Roberts, C A, and Manchester, K, 2005, The archaeology of disease, Third edition, Stroud















