First European exposure to syphilis: the Dominican Republic at the time of Columbian contact.

Recognition of syphilis in Europe in the late 15th century and its prior absence suggest New World origin. Skeletal populations were examined from sites with documented Columbian contact in the Dominican Republic. Examination of 536 skeletal remains revealed periosteal reaction characteristic of treponemal disease in 6%-14% of the afflicted population. Findings were identical to that previously noted in confirmed syphilis-affected populations and distinctive from those associated with yaws and bejel: it was a low population frequency phenomenon, affecting an average of 1.7-2.6 bone groups, often asymmetric and sparing hands and feet, but associated with significant tibial remodeling. While findings diagnostic of syphilis have been reported in the New World, actual demonstration of syphilis in areas where Columbus actually had contact was missing, until now. The evidence is consistent with this site as the point of initial contact of syphilis and of its subsequent spread from the New World to the Old.

Calcium pyrophosphate deposition disease: description in defleshed skeletons.

The osseous appearance, skeletal distribution, and distinguishing features of calcium pyrophosphate deposition disease (CPPD) were delineated in a population of 2906 contemporary defleshed skeletons. The limitations of routine x-ray and clinical examination were transcended in this study of defleshed bones. The nature of the disease was clearly identified and preconceived notions (based on the "shades of black and white" of the conventional x-ray technique) were examined on the basis of the actual osseous impact. Epidemiologic assessment of this disease allowed it to be distinguished from rheumatoid and other erosive forms of arthritis. Analysis of the "pseudo-rheumatoid" subgroup of CPPD provided clear criteria for distinguishing the disease from rheumatoid arthritis. Characterization of the nature and epidemiology of osseous alterations in a contemporary skeletal population permitted the development of a standard for recognition of CPPD in skeletal populations and for clarification of the nature of associated pseudo-erosions.