Ankylosing Hyperostosis

Site: Guisborough Priory.
Period: Medieval.
Excavator: Cleveland Archaeology (now Tees Archaeology).
Published: Archaeologia Aeliana Vol. ?.
Skeleton: male in middle age.

Catalogue entry: Gross osteophytosis affected the thoracic and lumbar vertebrae, all of which were either already ankylosed or in the process of becoming so. Large bulbous growths of bone were present on the right, especially on the lumbar vertebrae. There was no fusion of the facets, and the disc spaces were intact. This lesion of the spine is described by Forestier as ankylosing hyperostosis.

The presence of these lesions were suggestive of diffuse idiopathic skeletal hyperostosis (DISH). This is a condition which is particularly prevalent in middle aged and older men and can be associated with heavy drinking and late-onset diabetes. In the archaeological record, it commonly occurs amongst skeletons excavated from monastic sites. This does not necessarily imply that the disease was affecting monks, as wealthy lay patrons were often buried in these cemeteries.

Ankylosing Spondylitis

Site: The Hirsel churchyard, Coldstream, Scotland.
Period: Medieval.
Excavator: Prof. R.J. Cramp, Durham University.
Published: forthcoming (Historic Scotland?).
Skeleton: male in old age.

Catalogue entry: This disease is an inflammatory arthritis of unknown cause, which works progressively up the spine from the pelvis, bringing increasing immobility as the joints are fused. It occurs mainly in men and usually begins at a relatively early age (c.30). This man had, however, survived into old age.

This case is a classic example of the disease, with fusion of the sacro-iliac joints and ankylosis of the complete thoracic and lumbar spine, including the costovertebral joints. The spine is almost completely rigid. In the lumbar vertebrae only the lateral edges of the vertebral bodies are joined, but the spinous processes have become a solid mass extending up to the T10 vertebra. The spine is kyphotic (bent forward) around the T8-9 area. The sterno-manubrial joint is also fused.

Spina bifida occulta (cleft neural arch defect)

Site: The Hirsel churchyard, Coldstream, Scotland.
Period: Medieval.
Excavator: Prof. R.J. Cramp, Durham University.
Published: forthcoming (Historic Scotland?).
Skeleton: male, middle-aged to old.

Catalogue entry: This is a good example of the condition, with complete opening of the neural canal. This is a cleft neural arch defect and is developmental in origin, although it can be congenitally determined. In most cases, this type is symptomless in life. It is not related to true spina bifida, which would have resulted in early death in the past.