Coexistence of melorheostosis and DISH in a female skeleton from Magna Graecia (Sixth Century BC).

This paper reports on a case of massive hyperostotic alterations observed in the skeleton of an adult woman from the necropolis of Montescaglioso Belvedere (Basilicata, Southern Italy) attributed to the Enotrian culture and dated to the 6th century BC. Hyperostotic changes involve joints, the vertebral column, and the lower limbs. In particular, the large flowing ossification in both the thoracic (T6-T10) and lumbar (L2-L5) tracts, the sacralization of L5, accompanied by sacroiliac fusion on the left side, and the proliferative bone production on both the metaphyseal portion of the left tibia and the left third metatarsal are described. The vertebral antero-lateral ossification and the sacroiliac fusion support a diagnosis of diffuse idiopathic skeletal hyperostosis (DISH), while the flowing bone formation on the lower limbs supports a diagnosis of melorheostosis. The pathological conditions described here were already described in the literature, but this is the first reported case of the coexistence of DISH and the very rare melorheostosis. Furthermore, the skeleton from Montescaglioso Belvedere represents the first case of this disease described for ancient Europe, therefore adding a valuable contribution to the reconstruction of the antiquity and distribution of skeletal dysplasias.

Brief communication: a possible case of melorheostosis from antiquity.

An unusual case of discontinuous hard tissue hyperostosis is described in a 25-30-year-old female dating between 4000 and 5500 BP from northern Chile. This specimen was one of 104 individuals examined from the Morro-1 site, which is known to represent the Chinchorro culture. The only other reported case from antiquity dates to 500 AD (Lester [1969] J. Bone Joint Surg. [Am.] 49:142-143). A review and comparison of this case to the medical literature supports a diagnosis of melorheostosis. Differential diagnosis is presented with the ruling out of nonspecific manifestations of osteomyelitis/periostitis as the most likely alternative diagnosis.