A spotlight on our PhD members: Davina Craps & Katrien Van de Vijver

A spotlight on our PhD members: Davina Craps & Katrien Van de Vijver

This month, our members, Dr. Davina Craps and Dr. Katrien Van de Vijver, present their doctoral thesis. We have now two important works respectively on methodologies for joint diseases and on palaeodemography and palaeopathology for a large archaeological site.

Davina katrien phd members september spotlight main banner 1

The doctoral thesis of Dr. Davina Craps (Durham University) dealt with the topic of joint disease in palaeopathology, more specifically with a methodological reappraisal of osteoarthritis and rheumatoid arthritis.

 

Exploring New Research Avenues for Osteoarthritis and Rheumatoid Arthritis in Palaeopathology: An Interdisciplinary Approach with a Focus on Methodological Techniques.

 

Summary:

The main aim of this project was to examine and critically evaluate current methodologies for the analysis and interpretation of osteoarthritis and rheumatoid arthritis within palaeopathology, with reference to clinical research, historical sources, and art historical material. For osteoarthritis, five Post-Medieval populations were examined from the North of England. For rheumatoid arthritis the five previous populations, along with some collections from the Museum of London were examined to find cases of the condition.

A compartmental recording method was developed for osteoarthritis, this subsisted of, for example, dividing the shoulder into the acromioclavicular and the glenohumeral joint, or the elbow in the ulnohumeral and radiohumeral joints, and the knee joint firstly into the patellofemoral and tibiofemoral joints and then into the medial and lateral compartments. A detailed recording of the wrists, hands, ankles and feet was also maintained. In the diagnosis of osteoarthritis an important distinction was made between so-called degenerative joint changes (DJC), which consisted of joints affected by a minimum of two degenerative changes (marginal osteophytes, central osteophytes, porosity, and joint contour change), and osteoarthritis (OA), when the joint was affected by eburnation. This distinction was based on debate in the palaeopathological literature. This method was applied to the analysis of five Post-Medieval skeletal populations from both rural and urban sites from northern England. An analysis of the pattern and distribution of osteoarthritis and DJC between the sites, including rural versus urban differences, age and sex-specific comparisons, and, where possible, a comparison with contemporaneous sites from southern England was undertaken. For rheumatoid arthritis a set of diagnostic criteria was developed, applied, and tested on potential cases of the condition within the archaeological record. Given this condition’s scarcity within the palaeopathological context, a wider geographical and temporal analysis was conducted.

The results and discussion, based on clinical research and differential prevalence rates, indicated that DJC and osteoarthritis should be assessed separately. General rural-urban patterns were similar for DJC, even when correlated with age or sex, however this was not the case for osteoarthritis. This could indicate that there is a difference between the rural-urban environments that might facilitate the development of OA, but that DJC development is not affected by environmental factors. However this project also highlighted that more attention should be paid to the multifactorial origins of both osteoarthritis and rheumatoid arthritis when attempting to identify causative factors. The compartmental approach for osteoarthritis also found differential distributions between mobile and stable elements of ball-and-socket joints and between skeletal elements in hinge joints respectively. This could be attributed to differential osteophyte development, which has its basis in biomechanics (An article on this particular subject is currently under final review for the International Journal of Palaeopathology). The results were compared with clinical research to explore the impact of degeneration on the daily lives of past individuals, while not relying on activity reconstruction.  A multitude of questions were posed and answered during this project and in the future this information will be published.

The results and discussion for rheumatoid arthritis tested the new set of diagnostic criteria and integrated clinical, palaeopathological, and historical sources to create an interdisciplinary understanding of the condition. A compendium was created with information on the clinical background of the disease, known and new palaeopathological cases, historical and art-historical sources, and the debate on the history of the disease. This was essential to create a better understanding of rheumatoid arthritis, which is an uncommon find in palaeopathological research, whereas it is the most common erosive joint disease in the world today. The set of diagnostic criteria proved vital in identifying new cases and will continue to be tested in the future. A visual comparative database of lesions related to rheumatoid arthritis was also created. An article was published on a sub-section of this subject by Craps and Gowland (2015). Finally all the information gathered by the author was used to re-assess the debate on the origins of the disease.

            This project highlighted the importance of a re-analysis of the methodological approaches to joint diseases in palaeopathology. By utilizing more defined methodological approaches that are underlined by clinical and historical research it is possible to discover new patterns in disease distribution and to better understand how these diseases evolve through time. There are still many research topics related to osteoarthritis and rheumatoid arthritis that need to be explored, and palaeopathological analyses can continue to evolve and adapt alongside modern clinical research. Finally, this research demonstrated that there is so much more to the study of joint disease than debates concerning the reconstruction of past activity. Instead, palaeopathologists can make meaningful contributions towards understanding the complex aetiology and expressions of these commonplace conditions within different populations and over time.

 

Works mentioned:

  • Craps, D.D. and Gowland, R. (2015). “The Proximal Ulna as an Additional Diagnostic Feature of Advanced Rheumatoid Arthritis.” International Journal of Paleopathology 10, 26-30. doi: 10.1016/j.ijpp.2015.04.002.

  • Craps, D.D. – Compartmental Patterns of Degeneration in Ball-and-Socket Joints. (Submitted to International Journal of Paleopathology, under final revision).

 

Nowadays, Davina works as a freelance physical anthropologist (Osteoarc.be). You can check out her website here).

The doctoral thesis of Dr. Katrien Van de Vijver (KUL) concerns a case study of a large medieval and post-medieval cemetery, specifically dealing with palaeodemography & palaeopathology.

 

"The palaeodemographic and palaeopathological study of the St. Rombout's cemetery, Mechelen"

 

Summary

Contextual archaeo-anthropological studies – whereby skeletal and archaeological analyses are treated as one whole – are still uncommon. The detailed study of a sub-sample of 400 individuals from the excavation of St. Rombout’s cemetery in Mechelen, Belgium (10th-18th centuries AD) nevertheless demonstrates its enormous potential. The excavation resulted in the largest skeletal assemblage so far in Belgium, with over 4,000 individuals spread across more than eight centuries. Detailed on-site registration and archival documentation add to the exceptional nature of this collection.

A macroscopic study of mortality patterns and age and sex composition and the investigation of disease and trauma was combined with differential funerary practices and allowed the exploration of ‘who’ was buried in the churchyard, different socio-economic groups, burial customs and the physical health and lifestyle of the parish population. It also offered suggestions for circumstances of death for several unusual burials. 

Chronological changes were observed from the late medieval to post-medieval period. The main change was the appearance of a large group of adolescents (12-17 years) and young adults (18-25 years), mostly males, from the 15th-16th century layer onwards. Their less expensive and more unusual burials point towards a poorer and dependent social position. The individuals showed higher frequencies of growth disturbances, evidence of physical stress and disease. They may be servants, apprentices and immigrants and, considering the much higher proportion of males, may reflect the ‘extended male adolescence’ from medieval historical sources. A Spanish military hospital (1585-1715 AD) near the cemetery may also have affected the age and sex composition. For individuals over 25 years of age single graves and coffins were more common. They showed fewer indications for growth disturbances and lesions related to disease, which were more commonly healed, indicating these were stronger, surviving, individuals. Wealth and social position may have depended on age or social position could have affected the probability of reaching old age.

Patterns of physical stress varied between sexes and between age categories. Overall males showed more pronounced differences as they got older and seem to have achieved more evident changes in social position around 25 years of age. Females showed less marked differences, with an apparently lower impact of lifestyle on health. 

Several multiple burials were recorded, which indicate episodes of unusual mortality. They showed a large proportion of adolescents and young adults, who were almost all male. The high probability of death between 15-29 years of age was different from the single depositions and a natural mortality pattern, although it also does not illustrate a catastrophic mortality. The age and sex composition implies that the inclusion of individuals was likely related to both circumstances of death and socio-economic background, with higher numbers of poor and dependent individuals. They showed more pronounced evidence for growth disturbances, physical stress and disease and their background may have made them more likely to succumb to mortality crises. The lack of trauma inflicted around the time of death argues against violence, although a specific cause of death could not be established. Differences in burial organisation and age and sex composition between two groups suggest that they result from different circumstances. One group dated to the second half 15th century–early 17th century reflects more abrupt mortality crises, such as epidemics or famines, in the parish population. The other group, dated after 1640 AD and with individuals buried in different phases, may be connected to the Spanish military hospital.

Physico-chemical analyses confirmed the presence of lime in several burials and the analysis indicated the possibility of different motives, although disease could be proposed for several burials. The study of a mass grave with the remains of 41 executed brigands (1798 AD), allowed the reconstruction of the execution and a comparison to historical descriptions, some of which could be contradicted.

The results showed that the assemblage does not directly represent the original parish population and includes different social groups from the lower and middle classes, underlining the important question of representativeness. Gender and particularly age influenced the meaning of social roles and affected physical health and lifestyle.

 

Nowadays, Katrien works as a physical anthropologist. You can check out more of her work: http://kuleuven.academia.edu/KatrienVandeVijver & http://bareo.be/teams/van-de-vijver.html.

physical anthropology Osteoarc members