Differential diagnosis of a fused wrist with a partially destroyed capitate from Kazakhstan (1st–3rd century AD)

Abstract

We discuss here the differential diagnosis of carpal ankylosis along with the second and third metacarpals of the right hand in an adult male skeleton buried in a kurgan from Mayemer, Kazakhstan (86–242 AD, 95.4% cal.). Our assessment was conducted via macroscopic analysis as well as with the use of radiographic methods. Several groups of pathologies were considered: congenital diseases, inflammatory and infectious diseases, and trauma. Differential diagnosis was challenging due to the very poor preservation of the skeleton, and while several diseases are possible (e.g., rheumatoid arthritis, spondylarthropathy), we think the fusion is most likely of traumatic origin. Evidence for trauma was found, suggesting a scaphocapitate fracture syndrome, followed by ankylosis.