1
SITE CODE BA84 Palaeopathology
PBR
_____________________________________________________________________
Osteologist: Jelena Bekvalac
Date: 15.05.06
3274
_____________________________________________________________________
Context
An older male exhibiting multiple traumas:Severe trauma to the right acetabulum with an atrophic non-united fracture with four
non-united bone fragments
Well healed and aligned oblique fracture of the left tibia
Bilateral osteoarthritis of the acriomioclavicular joints, right acromion and proximal
phalanges of the 1st metacarpals
Unilateral spondylolysis of the left side
Well-healed and aligned fracture of the 5th metacarpal
Possible fracture at the distal end of the radii- to be x-rayed to be confirmed
Right Acetabulum
There was severe trauma & gross changes to the right acetabulum resulting in an
atrophic non-union fracture with four separate non-united bone fragments. The
acetabular surface had become shallow & increased in size with massive bone
formation, to the extent where the greater sciatic notch was virtually obscured. The
joint surface was coarse with macropororsity. The three larger non- united fragments
form the enlarged and extended anterior & mesial aspect of the acetabular rim.
There were bony spicules around the acetabulum causing a raised and irregular
surface and marked enthesopathies of the joint capsule. These were probably in
response to the severe trauma of the acetabulum. There was no indication of atrophy
of the femur, tibia or fibula suggesting that there was still movement of the hip joint,
even though it must have been severely impinged from the traumatic episode. The
marked muscle attachments would also seem to comply with this, as did the joint
surface changes of the knee joints’. The bony response to the trauma would appear
to indicate that the injury was long standing and that the individual suffered with its
consequences for an extended period of time.
Surprisingly the sacrum was not markedly affected with Grade 1 osteophytic lipping
of the first sacral body and the auricular surfaces.
Right Femoral Head
The femoral head was also grossly changed with an increase to its size with the
build up of coarse dense bone. The articular surface is distorted and irregular with
macroporosity and microporosity. It was difficult to establish if the femur head was
also fractured and an x-ray of the head should hopefully provide information
pertaining to this. The anterior aspect of the femoral neck was obscured with the
build up of a bony mass, which was damaged PM but may well have formed a bridge
with the bony changes of the acetabulum. On the anterior aspect of the femoral head
there was a ridge that was partially formed from the build up of bone. The muscle
attachment for gluteus minimus on the greater trochanter was marked, as was the
attachment for Gluteus maximus. As with the acetabulum the stress on the muscles
would have been increased and the impact of this may be seen in the right and left
femora.
Pathology Codes
congenital
infection
1512
joints
311
trauma
4210
4211
metabolic
endocrine
neoplastic
circulatory
other
2
SITE CODE BA84 Palaeopathology
PBR
_____________________________________________________________________
Osteologist: Jelena Bekvalac
Date: 15.05.06
3274
_____________________________________________________________________
Context
Vertebrae
There was osteophytic lipping of the cervical, thoracic and lumbar vertebrae but the
lipping became more severe in the lumbar vertebrae and may be associated with the
trauma to the left tibia and right acetabulum.
The anterior surface of L2 and L3 had bony outgrowths in the region of the anterior
spinal ligament. L2 also had the appearance of being reduced and diminished in
height, which may be associated with the changes on the anterior surface. It may
also be linked to the trauma of the right hip and left tibia.
Right 5th Metacarpal
A well-healed and aligned oblique fracture of the right 5th metacarpal at the distal
end. The distal joint surface had become slightly distorted with a smooth bony
tubercle, myostisis ossificans on the ventral surface and a smooth bony eminence
from the medial shaft surface. The joint surface had not been affected and only in
part had Grade 1 osteophytic lipping.
Left and Right Radii
Possible bilateral fracture of the radii at the distal end in the area most commonly
associated with a Colles fracture. There was a transverse line of slightly raised bone
that may have been an indication of a fracture. If not a complete fracture then
possibly they were hairline fractures indicating stress. Either resulting from the
trauma to the right hip and left tibia or from pressure placed on the arms
subsequently from the trauma.
The weight of load bearing when this individual walked would have been markedly
changed in this individual and shifted two fold because of the shortening of the left
tibia from the fracture and further from the severe trauma to the right hip joint. This
was seen further seen in the changes to the lumbar vertebrae and the bilateral
osteoarthritis of the acromioclavicular joints. If the individual was placing more
weight upon their arms this may have contributed to the osteoarthritis.
Pathology Codes
congenital
infection
1512
joints
311
trauma
4210
4211
metabolic
endocrine
neoplastic
circulatory
other