Periostitis: Clause, form and frequency in paleopathology

Abstract

Key words: Periostitis, paleopathology, Polish cemeteries. Periostitis, which accompanies the majority of disease processes, is one of the most important symptoms in paleopathology. Its characters manifested by intensity and location of the disease is very helpful in diagnosing. Some kinds of periostitis were well described in the excellent book on paleopathology by Ortner and Putschar (1981), yet to my mind a more thorough text on the subject is still very much awaited. As is already known from the rich paleopathological literature, periostitis is a main symptom of many diseases (Cockburn 1959, Stloukal, Vyhnanek 1976, Steinbock 1976, Brotwell 1976, Bennike 1985, Capasso 1985, GladykowskaRzeczycka 1989, 1993 a, 1993 b, Kihl 1995). Periosteal changes are known to be possibly limited to one bone only where the disease manifests less extensively, or they can be more generalized and seen in numerous bones. The picture of the disease can consequently be much differentiated and this results mainly from the fact that periosteal changes are due to numerous diseases many of an infectious kind including osteitis, syphilis, leprosies, tumors-as those of the lungscarcinoma, developmental disorders (pachydermoperiostitis), and endocrinologic disturbances like those of the pituitary gland. These diseases mainly cause generalized periostitis. Limited periosteal changes are usually due to local factors such as the varicose vein of crus. Periostitis can also be provoked by processes of unknown etiology. The picture provided by periosteal changes is now known to be dependent also on the phase of the disease (early, acute, chronic, recovering or healing) as well as on the age and immunity of the organism. Such a symptom as periostitis is therefore very difficult to systematize. Cases where periosteal changes are limited to a small area always present special difficulty since they may be due not only to a local factor (trauma, inflammatory process of soft tissue) but also to the acute, recovering or healing phase as observed in osteitis for example. Estimation of the cause of periostitis is experimentally known to be very difficult and that is mainly because of differences in bone preservation. The kind, location, intensity and incidence of periostitis therefore can only be assessed approximately. This paper is an attempt to present several cases with periosteal changes. The different kinds of periostitis which I encountered in my material are illustrated. In most cases a diagnosis was possible because of good bone preservation and the use of radiological examination, though in some cases the verdict remains questionable. Table I represents an attempt to systematize the periostitis changes observed in my material. The incidence of trauma-caused periostitis is demonstrated to be very high and the healing phase of the disease appears dominant. Periostitis as a result of limited tumors is sporadic, since the frequency of tumors is low in the material. Nonspecific inflammatory diseases are prevalent in the skull and are connected with teeth condition (abscesses, paradentosis). Osteitis is the second commonest disease with the chronic and healing phases dominating there. …