The human body, its organs and tissues, constantly interact with its external and internal environments throughout the individual's life span. Many disease processes impacting the internal environment of the organism leave revealing signs in the afflicted organ or tissue. If the individual survives the acute phase and the disease persists, those signs, which are evidence of the disease, can eventually impact the bony structures, leaving a permanent record that can survive for millennia. Unfortunately, soft tissues begin to decompose rapidly after death, and some of the signs of disease can be lost to this process. In contrast, the skeletal system will endure where organs may not and provide evidence of disease or injury, which can be detected radiographically. Some examples of disease patterns that can be seen on conventional radiographs include the following: calcified lesions in the pulmonary tissue, traumatic injury to bony structures, an assessment of fractures as to their pre- or perimortem status, shifted mediastinal structures, renal and bladder stones, lesions within bones (Pott's disease), gross morphologic variations in organs or bony structures, the impact of lesions on bony structures (sella turcica—pituitary lesions), and pelvic configuration as related to peripartum status. Morphological anomalies such as scoliotic
conditions can also be detected via radiography. Biomechanical stress is well recorded in the bony structures, particularly at the location of articulations. Arthritic changes and changes in bony structures as the result of repetitive activity can be demonstrated by conventional radiography.
Numerous paleopathological changes can be documented radiographically: a healed fracture of a humerus on a mummified Chinese immigrant (Figure 2.81) (Gallegos et al. 2002); a depressed skull fracture in the occipital bone, without healing, in an Egyptian mummy known as the Cook of Ra (Figure 2.82); what appears to be a compression fracture of a thoracic vertebrae in the lateral chest radiograph of this Chachapoya mummy (Figure 2.83) (Bravo et al. 2001); two radiographic examples of bladder stones (Figures 2.84A and 2.84B) (Bravo et al. 2003); avascular necrosis of the hip (Figure 2.85); and calcifications of arteries within the pelvis (Figure 2.86). It is important to note that although a disease, particularly
one within the remaining soft tissues, may be detected by radiograph, the specific disease can only be determined by a paleopathologist.
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