Palaeopathology of osteoarthritis

Palaeopathology is the study of disease in the past. Various different types of data can be used, including literature, paintings, and sculpture. In addition, for the rheumatic diseases, skeletal remains offer a particularly rich source of information for the palaeopathologist. This chapter only discusses the skeletal palaeopathology of osteoarthritis (OA). OA leaves characteristic imprints on the skeleton, such as osteophytes and bony sclerosis, which survive death, burial, and the recovery of skeletons. This has allowed researchers to compare the prevalence and distribution of OA within and between joints in skeletal collections obtained from different ancient populations in various countries. The data have shown that while OA has been common in all human populations studied, the nature, prevalence, and intra-articular distribution of the disease in different joints have probably changed over time. A high prevalence of elbow OA has been observed in many collections of human skeletons, suggesting that this joint may be more prone to the disease than generally thought, but that it might remain asymptomatic in the majority of people affected. In addition, skeletal palaeopathologists have found an association between osteophyte formation and enthesophytes, suggesting that some people may have a predisposition to osteoarticular changes characterized by new bone formation. OA has also been described and studied in different primate and other animal skeletons, providing further fascinating insights into the condition.