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    Back to Back: The Co-occurrence of DISH and Ankylosing Spondylitis from Early Modern Poland

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    Author
    Betsinger, Tracy K.
    Scott, Amy B.
    Keyword
    Spondyloarthropathy
    Sacroiliac fusion
    Extraspinal entheses
    Journal title
    International Journal of Paleopathology
    Date Published
    2023
    
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    URI
    http://hdl.handle.net/20.500.12648/12956
    Abstract
    Objective: This case study evaluates an individual with skeletal changes consistent with DISH and ankylosing spondylitis. We present here an evaluation of the individual’s pathological skeletal changes and a review of the potential diagnoses. Finally, we offer a differential diagnosis of co-morbidity infrequently found in the paleopathological record. Materials: The skeletal remains of a male, aged 50 + years from the early modern Polish (17th-18th century CE) site of Drawsko 1. Methods: Skeletal remains were examined for the presence of spondyloarthropathies. Results: The individual presented with anterolateral fusion of the vertebral bodies of T6-T10 with a “dripping candle wax” appearance, fusion of the right costovertebral joint at rib 8, fusion of the left apophyseal joints of T8-T10, and the calcification of the supraspinous ligament at T3-T4. The left sacroiliac joint shows intra-articular and para-articular fusion; the right has bony changes consistent with ongoing fusion. Entheseal reactions were noted on the left clavicle, scapulae, first metacarpals, ulnae, and humerii. Diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis (AS), reactive arthritis (RA), psoriatic arthritis (PA), and enteropathic arthritis (EA) are considered as differential diagnoses. Conclusions: Based on the skeletal pattern of involvement, the individual suffered from both DISH and AS, which has previously been reported once in the paleopathological literature since 1950. The clinical literature indicates that co-occurrence of these two conditions is possible, with approximately 40 individuals affected. Significance: This case study is significant for demonstrating the co-occurrence of DISH and AS in the paleopathological record. Additionally, this case contributes to the understanding of heterogenous frailty and syndemics. Limitations: No radiographs were taken to confirm the differential diagnosis. No aDNA analysis was conducted. Suggestions for further research: The remains have been reburied; no further analysis is possible.
    Citation
    Betsinger TK, Scott AB. 2023. Back to Back: The Co-occurrence of DISH and Ankylosing Spondylitis from Early Modern Poland. International Journal of Paleopathology 40:1-6.
    DOI
    https://doi.org/10.1016/j.ijpp.2022.11.002
    Accessibility Statement
    Electronic Accessibility Statement: SUNY Oneonta is committed to providing equal access to college information by ensuring our digital content is accessible by everyone regardless of physical, sensory, or cognitive ability. This item has been checked by Adobe Acrobat Accessibility Check and remediated with the following result: [Remediation: Title / Hazards: Alt Text]. To request further accessibility remediation on this SOAR repository item for your specific needs, please contact openaccess@oneonta.edu.
    ae974a485f413a2113503eed53cd6c53
    https://doi.org/10.1016/j.ijpp.2022.11.002
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