A case of bilateral scapholunate advanced collapse in a Romano-British skeleton from Ancaster

Abstract

Degenerative joint disease (DJD) of the wrist (radiocarpal joint) is relatively uncommon in modern Western populations, usually occurring as a result of trauma. Clinically, scapholunate advanced collapse (SLAC) is the most common pattern of DJD seen in the wrist, involving a progressive destruction of the radioscaphoid and then the capitolunate joint. There is only one report of SLAC wrist in the palaeopathological literature. In this paper, we report on another ancient case of bilateral SLAC wrists, found in a Roman skeleton from Ancaster, Lincolnshire. The osteological analysis of ANC 01 217 skeleton determined that this was an elderly but robust adult (50+ years) male, about 165 cm tall. The bones were sufficiently well preserved to allow inspection of joint surfaces. The bones were also radiographed. Osteoarthritis (OA) was diagnosed according to accepted palaeopathological criteria: principally the presence of eburnation on a joint surface. Eburnation was found at the articular surfaces of the wrist joint and numerous intercarpal joints bilaterally. The pattern of joints affected matched modern clinical descriptions of SLAC wrist. Radiographic changes characteristic of OA were identifiable at the wrist joint, but not at the intercarpal joints. This case proves that SLAC wrist is identifiable in dry bones, but the discrepancy between the observational and radiographic findings highlights the problems encountered when attempting to compare disease in archaeological versus modern populations. Copyright © 2006 John Wiley & Sons, Ltd.