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This skeleton is from the Hospital of St. James and St. Mary Magdalene, Chichester, a medieval leprosarium.   The individual had metastatic carcinoma of the prostate (prostate cancer).  Metastatic carcinoma of the prostate is characterised by osteosclerotic lesions and deposition of periosteal new bone (Ortner et al 1991). A mixture of pathological lesions distributed throughout the skeleton that are also consistent with the individual having co-existing leprosy.  However, bones from this individual that have leprous lesions or a mixture of lesions from both diseases have been omitted from this project to prevent confusion.

 

Chichester (CH86) 273

There are multiple destructive lesions throughout this individual’s skeleton.  More internal lesions are visible when the x-ray is viewed.  Many of the bones have large areas of active new bone (woven bone).

Cranium

The majority of the ectocranial surface is covered in diffuse fine pitting and porosity, with multiple localised areas of clustered porosity throughout.  There is a mixture of pitting, porosity and new woven bone covering a large area inferior to the temporal lines on the frontal and temporal on the left side and a smaller area on the left side in the same area, but more inferiorly.  The superior surface of the left orbit is covered in a patchy layer of new woven bone.  Similarly, the anterior half of the endocranial surface has irregular areas of new woven bone, especially along the sigmoid sinus and meningeal (arterial) grooves.

Mandible

The lingual and buccal surfaces of the right ascending ramus are covered in a layer of coarse woven bone.  The patchy distribution along these surfaces is likely due to post-mortem damage and would have been more extensive.  The left ramus has two small zones of new woven bone, one inferior to the mandibular notch on the buccal surface and the other on the medial side of the neck of the condylar process.  Both surfaces of the right ascending ramus and the lingual surface of the left side have scattered porosity.

Clavicle

The shaft has extensive porosity throughout and is covered in a layer of coarse woven bone in the middle two-thirds.   Post-mortem damage obscures the extent of the new bone formation; it is likely to have been more extensive as there are small patches of woven bone on the inferior surface of the acromial end.  A portion of the new bone on the inferior surface of the shaft exhibits areas of smoothing (remodelling).

Scapula

The majority of this bone is covered in multiple fine osteolytic lesions and a layer of coarse woven bone, sparing only areas of the blade and glenoid fossa.   Post-mortem damage obscures the extent of the new bone formation; it is likely to have been more extensive.

Ribs

There are multiple fine osteolytic lesions in areas of throughout the external surface of the rib bodies.  The visceral surfaces of the ribs have zones of new woven bone on the body, neck and head.  Post-mortem damage obscures the extent of the new bone formation; it is likely to have been more extensive.

Vertebrae

There are multiple fine osteolytic lesions on the anterior and lateral surfaces of the vertebral bodies.

Note:

Ortner D.J., Manchester K., and Lee F.  1991. Metastatic Carcinoma in a Leper Skeleton from a Medieval Cemetery in Chichester, England.  International Journal of Osteoarchaeology 1: 91-98.

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