Frequency and co‐occurrence of porous skeletal lesions in identified non‐adults from Portugal (19th to 20th centuries) and its association with respiratory infections as cause of death

Abstract

AbstractPorous skeletal lesions (PSL) have been reported in scientific literature since the 19th century, yet their etiology(ies) remains a complex issue under debate. The aim of this study is twofold: evaluate the frequency, co‐occurrence, and association of PSL with biological sex and age at death and examine possible relationships between the presence/absence of PSL with the known cause of death (COD). Fifty‐six non‐adult skeletons from the Coimbra Identified Skeletal Collection (19th to 20th centuries) were evaluated. Lesion presence/absence was recorded macroscopically without previous knowledge of the biographic data. Forty‐nine individuals (87.5%) presented at least one type of PSL, and cribra femoralis was the most frequent (n = 39), followed by orbitalia (n = 26), humeralis (n = 15), and cranii (n = 6). Porous skeletal lesions affected males and females equally, and younger individuals presented a significantly higher frequency of cribra femoralis. Even without statistical significance, the co‐occurrence of cribra orbitalia, humeralis, and femoralis was common, as described in the “cribrous syndrome” where it is advocated a shared etiology for these lesions, based on macroscopic, microscopic, and radiological features. Individuals with a COD as respiratory infection, particularly pulmonary tuberculosis, exhibited a higher risk of expressing cribra orbitalia. The results of this investigation suggest an influence of age and infectious diseases in the expression of PSL, impacting the bioarchaeological interpretations. There is a need for further research in clinical, autopsy, and identified skeletal collection samples to further understand co‐occurrence, comorbidity, and possible frailty related to PSL.