A case of rheumatoid arthritis in a Nubian woman from the site of Sheikh Mohamed, near Aswan, Egypt.

OBJECTIVE: To differentially diagnose and contextualize pathological lesions suggestive of rheumatoid arthritis. MATERIALS: The skeletal remains of a 25-30-year-old female dated to c. 1750-1550 BCE from a Nubian Pan-Grave cemetery at the site of Sheik Mohamed, near Aswan, Egypt. METHODS: The skeletal remains were examined macroscopically and a differential diagnosis was conducted following established protocols in the palaeopathological literature. RESULTS: Symmetrical, bilateral, erosive periarticular lesions with smooth edges were observed in multiple joints (especially in the hands and feet). CONCLUSIONS: Differential diagnosis suggests this individual had rheumatoid arthritis. SIGNIFICANCE: This case suggests the presence of rheumatoid arthritis in ancient Egypt, contributing to a more finely grained understanding of the antiquity and geographical distribution of the condition. LIMITATIONS: It was not possible to radiograph the skeletal remains. SUGGESTIONS FOR FURTHER RESEARCH: Researchers are encouraged to re-examine any archaeological examples of erosive polyarthropathy using current palaeopathological protocols and to explore the manifestation of rheumatoid arthritis on the African continent.

Forgotten and found: A case of childhood rickets in the 19th-century settler village of Heuvelton, New York.

OBJECTIVE: To evaluate pathological lesions suggesting the presence of rickets and to place the diagnosis into bioarchaeological and historical context. MATERIALS: The remains of a 3-year ± 12-month-old child discovered during a rescue excavation in Heuvelton, New York. METHODS: We examined the individual macroscopically and conducted a differential diagnosis following established protocols in the palaeopathological literature. RESULTS: Bony change on the orbits, mandible, ribs, clavicles, left scapula, humerii, radii, ulnae, femora, tibiae, fibulae (e.g., porosity, diaphyseal thickening, flaring, bowing), and dental lesions were recorded. CONCLUSIONS: We demonstrate that the child likely presented with vitamin D deficiency rickets during crawling and as they learned to walk. SIGNIFICANCE: This example offers an important contribution to the bioarchaeological literature, as few cases of rickets have been recorded in rural North America using updated diagnostic criteria and little is known of the health and lifeways of early settlers in 19th-century upstate New York. LIMITATIONS: It is not possible to ascertain the precise aetiology of this child's rachitic state and to compare this individual with others in the population. SUGGESTIONS FOR FURTHER RESEARCH: Examination (and re-assessment) of other North and South American skeletal assemblages for signs of vitamin D deficiency rickets following current bioarchaeological standards.

A possible "grinder" from Tell Arbid, Syria.

ABSTRACT: Cereal grinding has been practiced in Mesopotamia since the Upper Palaeolithic. While evidence of cereal grinding is clear from the archaeological and textual records, what remains unclear is whether the activity leaves signs on the skeleton in the form of markers of occupational stress (MOS). A particular constellation of MOS (e.g., osteoarthritis, traumatic injuries, and accessory articular facets) has previously been used to infer the habitual grinding of grain. These same MOS were recently observed in the skeleton of a female discovered in the Middle Bronze Age cemetery at Tell Arbid, NE Syria. Through differential diagnosis our results suggest that it remains problematic to identify grain-processing activities from the skeleton, even when a bioarchaeological approach is carried out.

Isotope evidence for agricultural extensification reveals how the world's first cities were fed.

This study sheds light on the agricultural economy that underpinned the emergence of the first urban centres in northern Mesopotamia. Using δ13C and δ15N values of crop remains from the sites of Tell Sabi Abyad, Tell Zeidan, Hamoukar, Tell Brak and Tell Leilan (6500-2000 cal bc), we reveal that labour-intensive practices such as manuring/middening and water management formed an integral part of the agricultural strategy from the seventh millennium bc. Increased agricultural production to support growing urban populations was achieved by cultivation of larger areas of land, entailing lower manure/midden inputs per unit area-extensification. Our findings paint a nuanced picture of the role of agricultural production in new forms of political centralization. The shift towards lower-input farming most plausibly developed gradually at a household level, but the increased importance of land-based wealth constituted a key potential source of political power, providing the possibility for greater bureaucratic control and contributing to the wider societal changes that accompanied urbanization.

First probable case of scurvy in ancient Egypt at Nag el-Qarmila, Aswan.

To date there has been a lack of palaeopathological evidence for the presence of scurvy in ancient Egypt. In this paper we describe one of, if not the first, differentially diagnosed bioarchaeological cases of subadult scurvy in the region in the skeleton of a 1-year +/- 4-month old infant recovered from the Predynastic site of Nag el-Qarmila (c. 3800-3600 BCE) in Aswan, Egypt. Bony change was observed on the left maxilla and greater wing of the sphenoid bone, left and right mandibular rami, orbits, and zygomatic bones, as well as on the humeri, radii, and femora, all of which appear to be suggestive of scurvy. While the cause of this infant's probable scorbutic state is unknown, various circumstances such as diet and cultural behaviors may have contributed to the condition. Given the current lack of evidence of scurvy from ancient Egyptian contexts, this case study informs on the antiquity of ascorbic acid deficiency in the Old World.