Periosteal new bone formation (PNBF) is a common finding in a large spectrum of diseases. In clinical practice, the morphology and location of periosteal lesions are frequently used to assist in the differential diagnosis of distinct bone... more
Periosteal new bone formation (PNBF) is a common finding in a large spectrum of diseases. In clinical practice,
the morphology and location of periosteal lesions are frequently used to assist in the differential diagnosis of
distinct bone conditions. Less commonly reported is the presence of PNBF on the ribs. This contrasts with the
data retrieved from the study of skeletonized human remains that shows a high frequency of cases and a
strong, albeit not specific, association between periosteal rib lesions and pulmonary conditions (e.g.
tuberculosis). Despite that, an overall disagreement regarding the specificity and non-specificity of periosteal
reactions exists in the study of dry bone remains. The insufficient number of clinical models exploring the
morphology and the pathophysiology of PNBF’s and the lack of systematic studies of pathological samples with
a known diagnosis are claimed as major reasons for the disagreements. This study aimed to describe and
compare the macroscopic and the histomorphologic appearance of periosteal rib lesions and to discuss their
usefulness as diagnostic indicators. To pursue this goal, an assemblage of 13 rib samples (males = 11,
females = 2, mean age-at-death = 36.6 years old) was collected from the Luis Lopes Skeletal Collection (Museu
Nacional de Historia Natural e da Ci^encia, Universidade de Lisboa, Portugal). The assemblage belongs to
individuals who died from pulmonary-TB (group 1), non-TB pulmonary infections (group 2) and other
conditions (group 3). Prior to sample preparation, the ribs were visually inspected and the PNBF described
according to its thickness, the degree of cortical integration and the type of new bone formed (e.g. woven,
lamellar or both). After sampling, each bone sample was prepared for histological analysis under plane and
polarized light microscopy. Macroscopically, the results showed no differences in the new bone composition
between cause-of-death groups. Only slight differences in the degree of cortical integration, which was most
frequently classified as mild to high in the pulmonary-TB group, were observed. Histologically, no
distinguishing features were identified by pathological group. However, new bone microarchitectures were
observed compatible with (1) acute, fast-growing processes (e.g. spiculated reactions), (2) long-standing
processes with a rapid bone formation (e.g. appositional layering of bone) and/or (3) chronic, slow-growing
processes (e.g. layers of compact lamellae). To some extent, these distinct rates of disease progression resonate
with the cause-of-death listed for some individuals. Despite the small sample size, the results of this
investigation are in agreement with previous studies, according to which the macroscopic and histological
appearance of periosteal formations are not specific for a particular pathological conditions. Nevertheless, the
results support the conclusion that the morphology of periosteal lesions is a good biological indicator for
inferring the rate of progression and duration of pathological processes. This study provides important reference data regarding the histomorphology of periosteal lesions that can be used for comparative purposes,
as well as to narrow down the differential diagnosis in unidentified skeletal remains.
the morphology and location of periosteal lesions are frequently used to assist in the differential diagnosis of
distinct bone conditions. Less commonly reported is the presence of PNBF on the ribs. This contrasts with the
data retrieved from the study of skeletonized human remains that shows a high frequency of cases and a
strong, albeit not specific, association between periosteal rib lesions and pulmonary conditions (e.g.
tuberculosis). Despite that, an overall disagreement regarding the specificity and non-specificity of periosteal
reactions exists in the study of dry bone remains. The insufficient number of clinical models exploring the
morphology and the pathophysiology of PNBF’s and the lack of systematic studies of pathological samples with
a known diagnosis are claimed as major reasons for the disagreements. This study aimed to describe and
compare the macroscopic and the histomorphologic appearance of periosteal rib lesions and to discuss their
usefulness as diagnostic indicators. To pursue this goal, an assemblage of 13 rib samples (males = 11,
females = 2, mean age-at-death = 36.6 years old) was collected from the Luis Lopes Skeletal Collection (Museu
Nacional de Historia Natural e da Ci^encia, Universidade de Lisboa, Portugal). The assemblage belongs to
individuals who died from pulmonary-TB (group 1), non-TB pulmonary infections (group 2) and other
conditions (group 3). Prior to sample preparation, the ribs were visually inspected and the PNBF described
according to its thickness, the degree of cortical integration and the type of new bone formed (e.g. woven,
lamellar or both). After sampling, each bone sample was prepared for histological analysis under plane and
polarized light microscopy. Macroscopically, the results showed no differences in the new bone composition
between cause-of-death groups. Only slight differences in the degree of cortical integration, which was most
frequently classified as mild to high in the pulmonary-TB group, were observed. Histologically, no
distinguishing features were identified by pathological group. However, new bone microarchitectures were
observed compatible with (1) acute, fast-growing processes (e.g. spiculated reactions), (2) long-standing
processes with a rapid bone formation (e.g. appositional layering of bone) and/or (3) chronic, slow-growing
processes (e.g. layers of compact lamellae). To some extent, these distinct rates of disease progression resonate
with the cause-of-death listed for some individuals. Despite the small sample size, the results of this
investigation are in agreement with previous studies, according to which the macroscopic and histological
appearance of periosteal formations are not specific for a particular pathological conditions. Nevertheless, the
results support the conclusion that the morphology of periosteal lesions is a good biological indicator for
inferring the rate of progression and duration of pathological processes. This study provides important reference data regarding the histomorphology of periosteal lesions that can be used for comparative purposes,
as well as to narrow down the differential diagnosis in unidentified skeletal remains.
Research Interests:
In 2015, several disarticulated human skeletal remains were identified in the top layers of the prehistoric site of Buraca da Moira Rock Shelter (Boa Vista, Leiria), during the archaeological excavation carried out under the scope of the... more
In 2015, several disarticulated
human skeletal remains were identified in the
top layers of the prehistoric site of Buraca da
Moira Rock Shelter (Boa Vista, Leiria), during
the archaeological excavation carried out
under the scope of the EcoPLis — Human
Occupations in the Pleistocene Ecotones of
the River Lis project. The recovery of chert,constiquartz
and quartzite blanks, a schist plate, as
well as adornments in bone and shell indicates
a Late Neolithic-Chalcolithic chronology. The
disarticulated human assemblage, composed
of a total of 129 bone and tooth fragments,
allowed the estimation of a minimum
number of six individuals. Among the remains
recovered, an upper portion of an adult
right ulna lacking the coronoid process was
identified. Replacing it, a semi-oval groove
with smooth contours and exposing some
trabecular bone was observed. The location,
type of bone change, and the observed
signs of bone healing are consistent with an
uncommon trauma: a fracture of the coronoid
process. In the differential diagnosis, both
postmortem changes and developmental
disturbances were considered but later
excluded. The mechanisms that underlie the
bone changes are discussed in light of the
clinical and paleopathological literature.
human skeletal remains were identified in the
top layers of the prehistoric site of Buraca da
Moira Rock Shelter (Boa Vista, Leiria), during
the archaeological excavation carried out
under the scope of the EcoPLis — Human
Occupations in the Pleistocene Ecotones of
the River Lis project. The recovery of chert,constiquartz
and quartzite blanks, a schist plate, as
well as adornments in bone and shell indicates
a Late Neolithic-Chalcolithic chronology. The
disarticulated human assemblage, composed
of a total of 129 bone and tooth fragments,
allowed the estimation of a minimum
number of six individuals. Among the remains
recovered, an upper portion of an adult
right ulna lacking the coronoid process was
identified. Replacing it, a semi-oval groove
with smooth contours and exposing some
trabecular bone was observed. The location,
type of bone change, and the observed
signs of bone healing are consistent with an
uncommon trauma: a fracture of the coronoid
process. In the differential diagnosis, both
postmortem changes and developmental
disturbances were considered but later
excluded. The mechanisms that underlie the
bone changes are discussed in light of the
clinical and paleopathological literature.
Research Interests:
Research Interests:
In the year of 2015, the Group of Studies in Human evolution (GEEvH) completed ten years of existence. Since its foundation, GEEvH's has played an important role in the difficult task of communicating science in Portugal in the field of... more
In the year of 2015, the Group of Studies in Human evolution (GEEvH) completed ten years of existence. Since its foundation, GEEvH's has played an important role in the difficult task of communicating science in Portugal in the field of human evolution. In this paper, an overview of the main activities developed by GEEvH in the last decade as well as upcoming goals, will be provided. This approach will be framed by a short theoretical introduction to Charles Darwin's
Research Interests:
Objectives: Bone trauma is a common occurrence in human skeletal remains. Macroscopic and imaging scrutiny is the approach most currently used to analyze and describe trauma. Nevertheless, this line of inquiry may not be sufficient to... more
Objectives: Bone trauma is a common occurrence in human skeletal remains. Macroscopic and imaging scrutiny is the approach most currently used to analyze and describe trauma. Nevertheless, this line of inquiry may not be sufficient to accurately identify the type of traumatic lesion and the associated degree of bone healing. To test the usefulness of histology in the examination of bone healing biology, we used an integrative approach that combines gross inspection and microscopy. Materials and Methods: Six bone samples belonging to 5 adult individuals with signs of bone trauma were collected from the Human Identified Skeletal Collection from the Museu Bocage (Lisbon, Portugal). Previous to sampling, the lesions were described according to their location, morphology, and healing status. After sampling, the bone specimens were prepared for plane light and polarized light analysis. Results: The histological analysis was pivotal: (1) to differentiate between types of traumatic lesions; (2) to ascertain the posttraumatic interval, and (3) to diagnose other associated pathological conditions. Conclusion: The outer surface of a bone lesion may not give a complete picture of the biology of the tissue's response. Accordingly, microscopic analysis is essential to differentiate, characterize, and classify trauma signs.
Research Interests:
Research Interests:
In the year of 2015, the Group of Studies in Human evolution (GEEvH) completed ten years of existence. Since its foundation, GEEvH's has played an important role in the difficult task of communicating science in Portugal in the field of... more
In the year of 2015, the Group of Studies in Human evolution (GEEvH) completed ten years of existence. Since its foundation, GEEvH's has played an important role in the difficult task of communicating science in Portugal in the field of human evolution. In this paper, an overview of the main activities developed by GEEvH in the last decade as well as upcoming goals, will be provided. This approach will be framed by a short theoretical introduction to Charles Darwin's
Research Interests:
The invention of the microscope revolutionized the course of human knowledge. This instrument changed the face of science and of previous beliefs, expanded the horizons of knowledge, and challenged philosophical and scientific thought,... more
The invention of the microscope revolutionized the course of human knowledge. This instrument changed the
face of science and of previous beliefs, expanded the horizons of knowledge, and challenged philosophical and scientific
thought, especially in the field of natural sciences and medicine. In the domain of bioarchaeology, the introduction of
histological techniques was important; not only to identify body tissues and to diagnose diseases in mummified remains, but
also to understand bone and teeth microstructure, and associated patterns of response to environmental constraints. In this
paper a critical review of the major contributions of histology to the growing body of knowledge in paleopathology and
bioarchaeology will be presented, focusing on the current multiple applications of microscopy, its limitations, and its future
challenges.
face of science and of previous beliefs, expanded the horizons of knowledge, and challenged philosophical and scientific
thought, especially in the field of natural sciences and medicine. In the domain of bioarchaeology, the introduction of
histological techniques was important; not only to identify body tissues and to diagnose diseases in mummified remains, but
also to understand bone and teeth microstructure, and associated patterns of response to environmental constraints. In this
paper a critical review of the major contributions of histology to the growing body of knowledge in paleopathology and
bioarchaeology will be presented, focusing on the current multiple applications of microscopy, its limitations, and its future
challenges.
Research Interests:
Research Interests:
The Workshop in Musculoskeletal Stress Markers (MSM): limitations and achievements in the reconstruction of past activity patterns, was held at the University of Coimbra, in Portugal (2nd – 3rd July 2009). The chief goal of the organizing... more
The Workshop in Musculoskeletal Stress Markers (MSM): limitations and achievements in the reconstruction of past activity patterns, was held at the University of Coimbra, in Portugal (2nd – 3rd July 2009). The chief goal of the organizing committee was to provide a productive environment where researchers could discuss the methodologies and terminology employed for the study of MSM as well as assessing how well these enthesopathies serve as markers of occupational stress. The Workshop was organized in three major sessions, each one introduced by a keynote lecture: (1) Methodological issues; (2) MSM studies of archaeological samples and Identified Skeletal Collections; and (3) The multifactorial etiology of enthesopathies. The meeting was concluded with a Plenary Session where two annotators discussed the presentations; this was followed by a general discussion and the formation of three working groups focused on the topics of Methods, Terminology, and Occupations. Details of the Workshop and the presentations presented are available for download at http://www.uc.pt/en/cia/msm/. A blog (http:// coimbraworkshopmsm.blogspot. com/) was created to facilitate communications about individual experiences and to share knowledge among researchers in this field. We hope that this Workshop will help to standardize methodologies and terminology and promote the creation of a more integrated scientific approach to future studies of MSM.
Identified osteological collections are important sources for pathological studies, especially when the causes of death of the individuals are known. However, the individual may have suffered from other disorders, not related to the death... more
Identified osteological collections are important sources for pathological studies, especially when the causes of death of the individuals are known. However, the individual may have suffered from other disorders, not related to the death and thus absent from written record of death. The aims of this paper are to describe the pathological signs perceptible on a skeleton, and to consider the possible aetiologies beyond the recorded cause of death. Skeleton number 470 belongs to the Identified Skeletal Collection of the University of Coimbra, Portugal. This female died in 1933, and pulmonary tuberculosis was recorded as the cause of death. The skeleton was observed macroscopically by the naked eye and with the help of a magnifying (10×) lens. Radiographic techniques were also applied. This individual presents skeletal abnormalities that include rib and vertebral agenesis, kyphoscoliosis, coxa vara in the right femur, left femoral head detachment with bone resorption in the corresponding acetabulum, and bilateral bowing of the fibulae. The differential diagnosis includes chromosomal or congenital, infectious, endocrine and metabolic diseases, with residual rickets the most probable pathological condition affecting this woman during her youth. This study shows that either in identified or unidentified skeletal samples, careful observation and a differential diagnosis is crucial.
Identified osteological collections are important sources for pathological studies, especially when the causes of death of the individuals are known. However, the individual may have suffered from other disorders, not related to the death... more
Identified osteological collections are important sources for pathological studies, especially when the causes of death of the individuals are known. However, the individual may have suffered from other disorders, not related to the death and thus absent from written record of death. The aims of this paper are to describe the pathological signs perceptible on a skeleton, and to consider the possible aetiologies beyond the recorded cause of death. Skeleton number 470 belongs to the Identified Skeletal Collection of the University of Coimbra, Portugal. This female died in 1933, and pulmonary tuberculosis was recorded as the cause of death. The skeleton was observed macroscopically by the naked eye and with the help of a magnifying (10×) lens. Radiographic techniques were also applied. This individual presents skeletal abnormalities that include rib and vertebral agenesis, kyphoscoliosis, coxa vara in the right femur, left femoral head detachment with bone resorption in the corresponding acetabulum, and bilateral bowing of the fibulae. The differential diagnosis includes chromosomal or congenital, infectious, endocrine and metabolic diseases, with residual rickets the most probable pathological condition affecting this woman during her youth. This study shows that either in identified or unidentified skeletal samples, careful observation and a differential diagnosis is crucial.
Studies on identified skeletal collections yield discordant results about the association between osseous changes and activity. These dissonances can be ascribed to several factors: the variability of the osseous changes selected for... more
Studies on identified skeletal collections yield discordant results about the association between osseous changes and activity. These dissonances can be ascribed to several factors: the variability of the osseous changes selected for observation, the inconsistency of their interpretative criteria and the inhomogeneous classification of occupation, here used as synonym of profession, within each study. The need to standardize the concept of occupation in its biomechanical and socio-cultural expression is currently addressed by the authors, as members of a working group created after the workshop ‘Musculoskeletal Stress Markers (MSM): limitations and achievements in the reconstruction of past activity patterns’ (Coimbra University, 2009). Within this framework, the authors reviewed the literature dedicated to entheseal changes and functional adaptation of long bones, focusing their research on studies based on European identified skeletal collections and on the criteria used in each study to classify occupations. The aim of this research was to (i) assess agreements and disagreements between authors with regard to the criteria used to categorize occupation, and (ii) highlight the steps needed to build a classification system permitting future comparisons between collections of different chronological and geographical contexts. Data from the literature were exported to a table including the assessment criteria used to classify the occupation for each profession and the assignment of specific occupations to occupational categories. Overall, our results revealed two main issues: an ambiguous historical interpretation of occupation and a marked influence of the researcher's perspective on the criteria used to classify occupations. Therefore, although the table allows basic comparisons between collections, further research is needed in order to obtain shared classifications based on each profession's specifics.
Hypertrophic osteoarthropathy (HOA) is characterized by symmetrical periosteal new bone deposition on the long and short tubular bones. Besides its unknown etiology, it has been associated with pulmonary, cardiovascular and... more
Hypertrophic osteoarthropathy (HOA) is characterized by symmetrical periosteal new bone deposition on the long and short tubular bones. Besides its unknown etiology, it has been associated with pulmonary, cardiovascular and gastrointestinal disorders. The aims of this research were to assess the presence of HOA and to analyze its distribution by sex, age at death, bones affected, type of new bone formed, and cause of death. A sample of 329 individuals (non-adults and adults, of both sexes) was selected from the Coimbra Skeletal Identified Collection. The sample comprised 125 individuals diagnosed with tuberculosis, 64 with pulmonary non-tuberculosis, and 140 with an extrapulmonary and non-tuberculous cause of death. Lesions compatible with HOA were found in all three groups, being statistically significantly in the individuals who died from pulmonary diseases (χ2 = 5.29, df = 1, p = 0.02). The risk of developing HOA was 3.41 (χ2 = 7.77, df = 1, p = 0.005) higher in the individuals with tuberculosis when compared with the other groups. This work, based on individuals who died before the introduction of antibiotics for treatment, agrees with clinical studies that have established a possible correlation between pulmonary conditions and HOA. These data may help in differentially diagnosing the many instances of periosteal new bone formation found in archaeologically derived skeletal samples.
The concept of evolution is fundamental to the teaching of biological sciences. Nevertheless, it seems frequently neglected and/or forgotten in our classrooms and absent from the school syllabus. These difficulties are present today in... more
The concept of evolution is fundamental to the teaching of biological sciences. Nevertheless, it seems frequently neglected and/or forgotten in our classrooms and absent from the school syllabus. These difficulties are present today in the Portuguese educational system, especially concerning the issue of human evolution. To overcome this difficulty, a multidisciplinary pilot project entitled Playing with the Big Tree of Evolution was developed by a nonprofit association called Group of Studies in Human Evolution in Portuguese schools and in other public and private organizations. Combining non-formal and informal apprenticeship, the project is composed of a set of pedagogical and experimental activities that aim to promote the broad concept of human evolution as well as to demystify the anthropocentric perspective that places humans at the top of the chain of life.
Trauma has incapacitated humans and their ancestors throughout time. Although, the interpretation of injuries aetiology among past populations is very difficult, if not impossible, especially in what concerns the study of interpersonal... more
Trauma has incapacitated humans and their ancestors throughout time. Although, the interpretation of injuries aetiology among past populations is very difficult, if not impossible, especially in what concerns the study of interpersonal violence. In this paper, the evidence of trauma was investigated in a well‑preserved skeletal from the roman necropolis of Quinta da Torrinha/Quinta de Santo António (Monte da Caparica) (AD III‑V). The skeleton of an elderly male, and probably a roman soldier, exhibits multiple fractures focalized in the right clavicle and first metacarpal bone, left ribs, vertebrae and sacrum. The right fibula exhibits a bone growth, eventually secondary to a muscle pull. The morphology and distribution of the lesions may suggest interpersonal violence, however, the skeletal evidence is rarely conclusive and the possibility of being the result of daily hazards can not be rejected.
O trauma é responsável por alguma incapacidade física entre os humanos actuais, tal como terá sido entre os nossos ancestrais. Apesar desta presença constante, a interpretação das lesões e a respectiva etiologia é bastante difícil em populações do passado, senão mesmo impossível, principalmente no que concerne ao estudo da violência interpessoal. Neste trabalho, as evidências de trauma foram investigadas num esqueleto bem preservado, exumado da necrópole romana da Quinta da Torrinha/Quinta de Santo António (Monte da Caparica) (séculos III‑V d.C.). O indivíduo idoso do sexo masculino, provavelmente um soldado romano, exibia múltiplas fracturas focalizadas na clavícula e no primeiro metacárpico direitos, nas costelas esquerdas, nas vértebras e no sacro. O perónio direito apresentava um crescimento ósseo, eventualmente secundário a uma luxação. A morfologia e a distribuição das lesões poderão sugerir violência interpessoal. O facto das evidências osteológicas não serem conclusivas, impede que se exclua a hipótese dos traumatismos decorrerem de acidentes.
O trauma é responsável por alguma incapacidade física entre os humanos actuais, tal como terá sido entre os nossos ancestrais. Apesar desta presença constante, a interpretação das lesões e a respectiva etiologia é bastante difícil em populações do passado, senão mesmo impossível, principalmente no que concerne ao estudo da violência interpessoal. Neste trabalho, as evidências de trauma foram investigadas num esqueleto bem preservado, exumado da necrópole romana da Quinta da Torrinha/Quinta de Santo António (Monte da Caparica) (séculos III‑V d.C.). O indivíduo idoso do sexo masculino, provavelmente um soldado romano, exibia múltiplas fracturas focalizadas na clavícula e no primeiro metacárpico direitos, nas costelas esquerdas, nas vértebras e no sacro. O perónio direito apresentava um crescimento ósseo, eventualmente secundário a uma luxação. A morfologia e a distribuição das lesões poderão sugerir violência interpessoal. O facto das evidências osteológicas não serem conclusivas, impede que se exclua a hipótese dos traumatismos decorrerem de acidentes.
During 2002, the extensive archaeological excavations of the ancient Constância necropolis (Centre of Portugal), dated from 14th-19th centuries, resulted in the exhumation of 151 individuals. Among the several paleopathological cases, a... more
During 2002, the extensive archaeological excavations of the ancient Constância necropolis (Centre of Portugal), dated from 14th-19th centuries, resulted in the exhumation of 151 individuals. Among the several paleopathological cases, a middle-aged female skeleton with osteolytic lesions in her skull, axial skeleton, upper limbs and femurs was observed. These pathological findings are characterised by an asymmetric pattern with osteolytic focus of distinct size and irregular shape. Some skeletal elements display both osteolytic and osteoblastic lesions. The latter exhibit deposition of fine layers of woven bone. Lesions were observed macroscopically and radiology was used as a complementary method of scrutiny, especially in cases of unclear observation. The case was diagnosed as that of a probable metastatic carcinoma due to the multifocal distribution of the lesions in areas of intense haematopoietic activity, their morphology and some osteoblastic responses, as well as the presence of pathological fractures in the ribs. The skeleton's sex and age at death are in agreement with the proposed diagnostic, constituting the first case of malignant carcinoma detected in non-identified Portuguese human skeletal remains.
Teeth preserve evidences of past populations lives. This study explores caries, dental wear, calculus, as well as signs of alveolar changes as proxy of behavior, health and environment interactions in a roman necropolis of Quinta da... more
Teeth preserve evidences of past populations lives. This study explores caries, dental wear, calculus, as well as signs of alveolar changes as proxy of behavior, health and environment interactions in a roman necropolis of Quinta da Torrinha/Quinta de Santo António (Almada, Portugal), dated 3rd-5th century AD. The sample is composed of 319 teeth, of 23 individuals (13 non-adults, 10 adults). Teeth were visually inspection, and changes recorded using standardized paleopathological methods. Caries (28/319; 8.8%) were recorded in eight individuals, mostly mature adults (>35 y.o.), with three adults presenting periapical voids. Calculus deposits were frequently seen in the anterior dentition, affecting 32.9% (105/319) of teeth. Dental wear was observed in 77.4% of teeth, with emphasis on the permanent upper left canine, central incisor, and the deciduae upper right and lower left central incisor. Most importantly, atypical dental wear (e.g., occlusal grooves, “cup-shaped” crown topography, and oblique wear) was observed on the dentition of two individuals, which may be related with dietary and parafunctional factors. The proximity of this necropolis with the Atlantic Sea and Tagus River may explain the results, as severe and atypical dental wear has been reported in populations with coastal subsistence strategies. Comparative studies with other coastal Roman samples could contribute to the understanding of the impact of human activity and subsistence on teeth structure and health.
Research Interests:
Differential diagnosis is a fundamental step in every paleopathological study. It is a challenging exercise since many extrinsic and intrinsic factors may negatively impact the accurate interpretation of bone changes in human skeletal... more
Differential diagnosis is a fundamental step in every paleopathological study. It is a challenging exercise since many extrinsic and intrinsic factors may negatively impact the accurate interpretation of bone changes in human skeletal remains. Among them, one may stress the limited range of bone tissue response to injury and disease, as well as the possible lack of completeness and preservation of the skeletal remains. This study aims to explore the limits of differential diagnosis in the analysis of fragmentary bone pieces. The sample consists of eleven adult long-bone specimens with exuberant changes. The specimens were identified in a non-articulated skeletal assemblage from the former necropolis of Juncal (Porto de Mós, Portugal), which probably ended functions in the late 19th century/early 20th century. The bone specimens were analysed through visual inspection and conventional X-radiography, and the changes carefully described prior to differential diagnosis. Five specimens presented signs of healed bone trauma (i.e., fracture) and one showed traits of a leg amputation. Periosteal lesions were observed in three bone pieces, one of them resembling an overlying skin ulcer. Two bone specimens were identified as belonging to the same individual due to the matching bone changes. Despite the incomplete remains, a broader diagnosis was possible for most cases, aided by the type and exuberance of the lesions. However, a differential diagnosis on the etiology of the changes is unattainable since we only have access to single bones rather than complete skeletons.
Research Interests:
46th Congress of ISHM (International Society for the Study of Medicine): Lisboa, Portugal Periosteal rib lesions are an occasional finding in clinical settings. This reality contrasts with the data retrieved from the study of... more
46th Congress of ISHM (International Society for the Study of Medicine): Lisboa, Portugal
Periosteal rib lesions are an occasional finding in clinical settings. This reality contrasts with the data retrieved from the study of skeletonized human remains that show a strong, albeit not specific, association between periosteal rib lesions and pulmonary conditions (e.g., tuberculosis). Taking into account the problematic of the specificity and non-specificity of periosteal reactions (PR), this study aims to describe and compare the macroscopic and the histomorphological appearance of periosteal rib lesions, and to discuss if it relates with the stage of development of the inciting process. To pursuit this goal, an assemblage of 15 rib samples (males=13, females=2, mean age-at-death= 41.8 years old) was collected from the Lisbon Human Identified Skeletal Collection, Museu Nacional de História Natural e da Ciência, Portugal. The assemblage belongs to individuals who died from of pulmonary-TB, non-TB pulmonary infections, and other conditions. Prior to sample preparation, the ribs were visually inspected and the PR described according to its thickness, degree of cortical integration, and type of new bone formed (e.g. woven, lamellar, or both). After sampling, each bone segment was prepared for histological analysis under plane and polarized light microscopy. The macroscopic and histologic analysis of PR revealed distinct appearances and microarchitectures (i.e., single layer, appositional, arc-like and “sunburst” formations) that seems to reflect the stage and duration of the underlying disease process. The differences found may be interpreted as the result of slow, indolent or chronic processes (e.g., appositional layering of new formation) or a response to fast or acute disease developments (e.g., “sunburst” formation). Other diagnostic possibilities are also explored. This study revealed that the histological analysis is useful to provide information on the aggressiveness and duration of disease processes that can be used to narrow down the differential diagnosis in unidentified cases.
Periosteal rib lesions are an occasional finding in clinical settings. This reality contrasts with the data retrieved from the study of skeletonized human remains that show a strong, albeit not specific, association between periosteal rib lesions and pulmonary conditions (e.g., tuberculosis). Taking into account the problematic of the specificity and non-specificity of periosteal reactions (PR), this study aims to describe and compare the macroscopic and the histomorphological appearance of periosteal rib lesions, and to discuss if it relates with the stage of development of the inciting process. To pursuit this goal, an assemblage of 15 rib samples (males=13, females=2, mean age-at-death= 41.8 years old) was collected from the Lisbon Human Identified Skeletal Collection, Museu Nacional de História Natural e da Ciência, Portugal. The assemblage belongs to individuals who died from of pulmonary-TB, non-TB pulmonary infections, and other conditions. Prior to sample preparation, the ribs were visually inspected and the PR described according to its thickness, degree of cortical integration, and type of new bone formed (e.g. woven, lamellar, or both). After sampling, each bone segment was prepared for histological analysis under plane and polarized light microscopy. The macroscopic and histologic analysis of PR revealed distinct appearances and microarchitectures (i.e., single layer, appositional, arc-like and “sunburst” formations) that seems to reflect the stage and duration of the underlying disease process. The differences found may be interpreted as the result of slow, indolent or chronic processes (e.g., appositional layering of new formation) or a response to fast or acute disease developments (e.g., “sunburst” formation). Other diagnostic possibilities are also explored. This study revealed that the histological analysis is useful to provide information on the aggressiveness and duration of disease processes that can be used to narrow down the differential diagnosis in unidentified cases.