Contribution to the debate on the origin of autoimmune joint diseases in Europe through an archaeological case of still's disease.

The objective of this study is twofold: (i) to evaluate the bony changes of an early medieval skeleton (UF2) from Barcelona, which presents lesions suggestive of Still's disease and (ii) to contribute to the debate concerning the existence of autoimmune joint diseases in Europe prior to Columbus's voyages. Macroscopic examination reveals a male between 45 and 50 years of age. Palaeopathological and radiological evaluation reveals the left carpal and carpometacarpal ankylosis, affecting the proximal epiphysis of the second to fifth left metacarpals, and the partial fusion of the C2 and C3 vertebral arches. Differential diagnosis of these lesions, their macroscopic and radiological appearance and the presence of C2-C3 fusion without odontoid erosions, as well as the asymmetry in the joint involvement, indicated Still's disease. This case provides a new evidence for autoimmune joint diseases in Europe prior to Columbus's voyages. The apparent increase in these diseases in Europe after the 17th century, could be attributed to the significant changes in lifestyle and diet that occurred in the early modern period. Although individual predisposition is crucial, other factors such as nutrition and lifestyle, which can both play an environmental role as triggers or therapeutic elements for these diseases, are also relevant.