{"title":"背靠背:来自波兰早期现代的DISH和强直性脊柱炎的共同发生","authors":"Tracy K. Betsinger , Amy B. Scott","doi":"10.1016/j.ijpp.2022.11.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>This case study evaluates an individual with skeletal changes consistent with DISH and ankylosing spondylitis. We present here an evaluation of the individual’s pathological skeletal changes and a review of the potential diagnoses. Finally, we offer a differential diagnosis of co-morbidity infrequently found in the paleopathological record.</p></div><div><h3>Materials</h3><p>The skeletal remains of a male, aged 50 + years from the early modern Polish (17th-18th century CE) site of Drawsko 1.</p></div><div><h3>Methods</h3><p>Skeletal remains were examined for the presence of spondyloarthropathies.</p></div><div><h3>Results</h3><p>The individual presented with anterolateral fusion of the vertebral bodies of T6-T10 with a “dripping candle wax” appearance, fusion of the right costovertebral joint at rib 8, fusion of the left apophyseal joints of T8-T10, and the calcification of the supraspinous ligament at T3-T4. The left sacroiliac joint shows intra-articular and para-articular fusion; the right has bony changes consistent with ongoing fusion. Entheseal reactions were noted on the left clavicle, scapulae, first metacarpals, ulnae, and humerii. Diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis (AS), reactive arthritis (RA), psoriatic arthritis (PA), and enteropathic arthritis (EA) are considered as differential diagnoses.</p></div><div><h3>Conclusions</h3><p>Based on the skeletal pattern of involvement, the individual suffered from both DISH and AS, which has previously been reported once in the paleopathological literature since 1950. The clinical literature indicates that co-occurrence of these two conditions is possible, with approximately 40 individuals affected.</p></div><div><h3>Significance</h3><p>This case study is significant for demonstrating the co-occurrence of DISH and AS in the paleopathological record. Additionally, this case contributes to the understanding of heterogenous frailty and syndemics.</p></div><div><h3>Limitations</h3><p>No radiographs were taken to confirm the differential diagnosis. No aDNA analysis was conducted.</p></div><div><h3>Suggestions for further research</h3><p>The remains have been reburied; no further analysis is possible.</p></div>","PeriodicalId":48817,"journal":{"name":"International Journal of Paleopathology","volume":"40 ","pages":"Pages 1-6"},"PeriodicalIF":1.3000,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"Back-to-back: The co-occurrence of DISH and ankylosing spondylitis from early modern Poland\",\"authors\":\"Tracy K. Betsinger , Amy B. Scott\",\"doi\":\"10.1016/j.ijpp.2022.11.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>This case study evaluates an individual with skeletal changes consistent with DISH and ankylosing spondylitis. We present here an evaluation of the individual’s pathological skeletal changes and a review of the potential diagnoses. Finally, we offer a differential diagnosis of co-morbidity infrequently found in the paleopathological record.</p></div><div><h3>Materials</h3><p>The skeletal remains of a male, aged 50 + years from the early modern Polish (17th-18th century CE) site of Drawsko 1.</p></div><div><h3>Methods</h3><p>Skeletal remains were examined for the presence of spondyloarthropathies.</p></div><div><h3>Results</h3><p>The individual presented with anterolateral fusion of the vertebral bodies of T6-T10 with a “dripping candle wax” appearance, fusion of the right costovertebral joint at rib 8, fusion of the left apophyseal joints of T8-T10, and the calcification of the supraspinous ligament at T3-T4. The left sacroiliac joint shows intra-articular and para-articular fusion; the right has bony changes consistent with ongoing fusion. Entheseal reactions were noted on the left clavicle, scapulae, first metacarpals, ulnae, and humerii. Diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis (AS), reactive arthritis (RA), psoriatic arthritis (PA), and enteropathic arthritis (EA) are considered as differential diagnoses.</p></div><div><h3>Conclusions</h3><p>Based on the skeletal pattern of involvement, the individual suffered from both DISH and AS, which has previously been reported once in the paleopathological literature since 1950. The clinical literature indicates that co-occurrence of these two conditions is possible, with approximately 40 individuals affected.</p></div><div><h3>Significance</h3><p>This case study is significant for demonstrating the co-occurrence of DISH and AS in the paleopathological record. Additionally, this case contributes to the understanding of heterogenous frailty and syndemics.</p></div><div><h3>Limitations</h3><p>No radiographs were taken to confirm the differential diagnosis. No aDNA analysis was conducted.</p></div><div><h3>Suggestions for further research</h3><p>The remains have been reburied; no further analysis is possible.</p></div>\",\"PeriodicalId\":48817,\"journal\":{\"name\":\"International Journal of Paleopathology\",\"volume\":\"40 \",\"pages\":\"Pages 1-6\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2023-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Paleopathology\",\"FirstCategoryId\":\"89\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1879981722000572\",\"RegionNum\":3,\"RegionCategory\":\"地球科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PALEONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Paleopathology","FirstCategoryId":"89","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1879981722000572","RegionNum":3,"RegionCategory":"地球科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PALEONTOLOGY","Score":null,"Total":0}
Back-to-back: The co-occurrence of DISH and ankylosing spondylitis from early modern Poland
Objective
This case study evaluates an individual with skeletal changes consistent with DISH and ankylosing spondylitis. We present here an evaluation of the individual’s pathological skeletal changes and a review of the potential diagnoses. Finally, we offer a differential diagnosis of co-morbidity infrequently found in the paleopathological record.
Materials
The skeletal remains of a male, aged 50 + years from the early modern Polish (17th-18th century CE) site of Drawsko 1.
Methods
Skeletal remains were examined for the presence of spondyloarthropathies.
Results
The individual presented with anterolateral fusion of the vertebral bodies of T6-T10 with a “dripping candle wax” appearance, fusion of the right costovertebral joint at rib 8, fusion of the left apophyseal joints of T8-T10, and the calcification of the supraspinous ligament at T3-T4. The left sacroiliac joint shows intra-articular and para-articular fusion; the right has bony changes consistent with ongoing fusion. Entheseal reactions were noted on the left clavicle, scapulae, first metacarpals, ulnae, and humerii. Diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis (AS), reactive arthritis (RA), psoriatic arthritis (PA), and enteropathic arthritis (EA) are considered as differential diagnoses.
Conclusions
Based on the skeletal pattern of involvement, the individual suffered from both DISH and AS, which has previously been reported once in the paleopathological literature since 1950. The clinical literature indicates that co-occurrence of these two conditions is possible, with approximately 40 individuals affected.
Significance
This case study is significant for demonstrating the co-occurrence of DISH and AS in the paleopathological record. Additionally, this case contributes to the understanding of heterogenous frailty and syndemics.
Limitations
No radiographs were taken to confirm the differential diagnosis. No aDNA analysis was conducted.
Suggestions for further research
The remains have been reburied; no further analysis is possible.
期刊介绍：
Paleopathology is the study and application of methods and techniques for investigating diseases and related conditions from skeletal and soft tissue remains. The International Journal of Paleopathology (IJPP) will publish original and significant articles on human and animal (including hominids) disease, based upon the study of physical remains, including osseous, dental, and preserved soft tissues at a range of methodological levels, from direct observation to molecular, chemical, histological and radiographic analysis. Discussion of ways in which these methods can be applied to the reconstruction of health, disease and life histories in the past is central to the discipline, so the journal would also encourage papers covering interpretive and theoretical issues, and those that place the study of disease at the centre of a bioarchaeological or biocultural approach. Papers dealing with historical evidence relating to disease in the past (rather than history of medicine) will also be published. The journal will also accept significant studies that applied previously developed techniques to new materials, setting the research in the context of current debates on past human and animal health.
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