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Part  Three:  Problems With Osteoarthritis

Joint diseases are a group of degenerative abnormalities, often referred to collectively as ‘arthritis’ which, although related, have different causes. Joint disease is  well-known in modern societies but there is also much evidence for its presence in ancient Egyptian and Nubian biological remains.  It is important to note that, nowadays, the medical profession does recognise a number of different types of degenerative conditions but in many of the early biological reports on ancient Egyptian and Nubian human remains the general term ‘arthritis’ was used to cover what would nowadays be regarded as separate degenerative conditions.  This article will concentrate on osteoarthritis.

Essentially, as the body ages so bones and joints experience wear and tear.  Whilst the majority of examples of osteoarthritic conditions are linked to the aging process it is important to stress that not all osteoarthritis is age-related.  Thus, evidence of osteoarthritis cannot be used reliably to assess the age at death of mummies and skeletons as forms of arthritis can occur in young individuals and it can occur as a response to infection (ie. infective arthritis) or trauma.  Let’s examine the situation further.

In part one of this series of health in ancient Egypt and Nubia we considered some commonly found dental conditions and it is a fact that osteoarthritis, together with dental conditions, are the most commonly found pathological conditions observed on the bodies of the ancient dead – whether they be Egyptian, Nubian, South American, European or from elsewhere.  In fact, from an excavation point of view, if the biological anthropologist examining the human remains does not  find many examples of these conditions (ie. osteoarthritis and dental conditions) then there are some interesting research questions to ask and answer!

Degenerative joint disease, as the name implies, affects the joints linking bones together.  Any joints can be affected – but some more so than others.  The knee joint (fig. 1) is commonly affected as the synovial joint here is easily changed by the aging process.

Image

fig. 1: Nubian adult male, knee joint (posterior view) exhibiting the bony spurs
of osteroarthritis

As a person ages so the cushioning provided by the synovial structure lessens, allowing the ends of the leg bones (tibia and femur) to rub together.  As a response the unprotected bones grow outwards widening the area of bone in an attempt to absorb the strain, almost like shock absorbers in a car!  However, the same situation can occur in younger people if the joints are overly stressed, as in the often heavy and repeated agricultural work of ancient Egypt and Nubia.  Additionally, it is important to note that septic arthritis can also occur,  caused by blood-borne bacteria entering the joint areas through a wound.  Again, this can occur at any age in life.  Thus, my earlier warning about using osteoarthritis in assessing age at death – the presence of osteoarthritis does not necessarily correlate with age.

In part two of this series I described how leg fractures in ancient times could heal but at a possible cost to the individual affected by the leg bone being shortened and causing an unsteady gait.  There could also have been an arthritic ‘cost’ involved.  If a person walks continually in an unbalanced manner because one leg is shorter than the other then it is likely that osteoarthritis will affect the hip joints as a consequence.  Thus, one health condition can lead to another.  It is a fact of life (then and now) that an individual may be afflicted with more than one medical condition.

Osteophytosis, a condition affecting the spine, is commonly seen in ancient Egyptian and Nubian human remains, especially in the neck and lower spinal areas.  Again, stress, and also wear and tear as a result of aging, causes the discs between the vertebrae to rupture.  The bone responds by growing  spurs of bone (osteophytes) along the edges of the vertebral body in order to redistribute the load, again like shock absorbers.  Sometimes these spurs of bone from individual vertebra can actually grow to such a length whereby they ‘lock’ together with bony spurs from the adjacent vertebra resulting in some degree of immobility.  Understandably, in this situation the affected person might have experienced a stiff back (fig. 2).

Image

fig. 2: section of spine showing osteophytic growths

In the vertebral bones featured in figure 2 the further growth progress of bony spurs have been prevented from locking together by the death of the individual concerned.

Osteoarthritis, affecting many joints in the skeleton, is a fact of modern life and and the evidence from ancient Egypt and Nubia demonstrates it was just the same in ancient societies.

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