Differential Diagnosis of Limb Length Discrepancy in a 19th Century Burial from Southwest Mississippi

Abstract

This paper reports on a 19th century skeleton from southwest Mississippi that displays shortening of several right side bones. Most notable is a 50-mm discrepancy in leg length involving the tibiae and fibulae. Osseous changes in the right foot suggest limited muscle function was present in this area. However, the shortened tibia and fibula show no signs of atrophy. After considering both osteological features and burial context, it is concluded that the individual was likely exposed to the poliovirus during childhood. While this diagnosis does not conform to the skeletal expectations of polio based on most paleopathological descriptions, the deformities observed fit within the range of what has been reported clinically. Based on this finding, it is suggested that polio should be considered as an etiological source of limb shortening even when signs of diffuse skeletal atrophy are lacking. Copyright © 2012 John Wiley & Sons, Ltd.