SITE CODE REW92 Palaeopathology PBR 1

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Context 84 Osteologist: R.N.R. Mikulski Date: 29/09/2005
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Summary: REW92 84 represents a perinatal individual of at least 31 weeks exhibiting advanced skeletal changes suggestive of a case of
either congenital syphilis or a chronic vitamin C deficiency probably occurring in vitro.

Cranial:

Both orbital rooves exhibit evidence of slight cribra orbitalia.

There is marked new bone plaque formation to the endocranial surface of the left frontal.

The endocranial aspect of the basioccipital exhibits a lesion which has a possibly erosive or lytic appearance.

There is marked pitting/porosity to the maxilla, while the anterior mandibular bodies exhibit marked porosity.

Postcranial:

The majority of the extant long bones exhibit porous new bone plaque formation to their diaphyses.

Scapulae: There is bilateral irregular porosity/new bone to the superior/inferior aspects of scapular spines.

Metacarpals: The extant metacarpals exhibit evidence of possible slight porosity to the diaphyses, although this might simply be growth-
related.

Ilia: Both ilia exhibit irregular porous new bone formation to both the ventral and the external aspects of their blades.

Pathology Codes
congenital infection joints trauma metabolic endocrine neoplastic circulatory other
222 521
SITE CODE REW92 Palaeopathology PBR 2
_____________________________________________________________________
Context 84 Osteologist: R.N.R. Mikulski Date: 29/09/2005
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Additional Observations:

Both tibiae appear to exhibit slightly enlarged nutrient foramina.

Discussion:

The skeletal changes observed in this individual are suggestive of either congenital syphilis or a chronic vitamin C deficiency. The young
perinatal age of the individual also suggests the possibility that the individual was stillborn or at least that the individual was suffering from the
condition to some degree in vitro.

The profuse porous new bone plaque formation to the long bones might be used to support either possibility (congenital syphilis or scurvy), but
the distribution and advanced nature of the new bone build-up in some bones (e.g. tibiae, femora, clavicles) might be interpreted as being
representative of a greater likelihood of congenital syphilis, particularly with the possibility of reactive changes in the extant hand bones which
might represent syphilitic dactylitis.

Although scurvy must remain a strong possible alternative, the skeletal changes are so advanced that, especially given the social context of this
cemetery site, it is not unreasonable to suggest this individual was more likely suffering from congenital syphilis.

Pathology Codes
congenital infection joints trauma metabolic endocrine neoplastic circulatory other
222 521