Abstract
ObjectivesInflammatory periosteal reaction (IPR) on the visceral surfaces of the ribs has been used in bioarchaeology as an indicator of lower respiratory tract disease. This article presents a detailed method for recording IPR on the ribs, even those in severely fragmented states, with the objectives of increasing the consistency of recording and producing true prevalence rates for skeletons so as to improve data comparability between future bioarchaeological studies of lower respiratory tract disease.Materials and methodsThe presence and prevalence of respiratory‐related IPR were recorded from three different Sudanese cemetery sites using a detailed method for identifying and recording IPR. Sites with variable preservation were chosen to test the applicability of the method. A flowchart to aid in identification of bony changes is presented. The method requires the recording of IPR on three separate sections of the rib (neck, angle, and shaft) and the allocation of ribs into rib cage regions of upper, upper‐middle, middle, lower‐middle, and lower.ResultsResults demonstrate differences in the distribution of IPR between sites and verify the method's applicability to archeological sites with various levels of skeletal preservation.DiscussionWhile crude prevalence rates can indicate the number of individuals experiencing lower respiratory tract disease within a site, this method can provide information about the distribution of IPR within the rib cage. This should lead to new ways of distinguishing respiratory diseases within archeological populations. This method also allows for comparability between well‐preserved and lesser‐preserved sites by accommodating for rib fragmentation.
Highlights
The presence of periosteal reaction, producing new bone on the cortical layer of the visceral surface of the ribs, from archeological skeletons has been used as evidence for lower respiratory tract disease in the archeological record
True prevalence rates were produced for all the sites according to each section of the rib by rib number (1–12) and side (Table 2), and by rib cage region and side (Table 3)
The prevalence rates for sites 3-Q-33 and 3-J-23 showed little to no variation between the section of rib affected, side of rib affected, and the whole rib cage when presented either by rib cage region or by rib number, with the greatest percentage difference being only 0.4% (3-Q-33, left shaft total prevalence)
Summary
The presence of periosteal reaction, producing new bone on the cortical layer of the visceral (inner) surface of the ribs, from archeological skeletons has been used as evidence for lower respiratory tract disease in the archeological record. It has been proposed that fluid or pus accumulation and inflammation within the pleural cavity, commonly caused by lower respiratory tract diseases, may in turn stimulate inflammatory periosteal reaction (IPR) on the visceral surfaces of the ribs (Kelley & Micozzi, 1984; Pfeiffer, 1991; Roberts, Boylston, Buckley, Chamberlain, & Murphy, 1998; Roberts, Lucy, & Manchester, 1994). Thickening of the ribs in radiographs, assumed to be chronic periosteal reaction leading to new bone formation, has been wileyonlinelibrary.com/journal/ajpa The most common respiratory infections to cause pleural inflammation include tuberculosis, pneumonia, and actinomycosis (Kass, Williams, & Reamy, 2007).
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