The Bioarchaeology of Metabolic Bone Disease

Acknowledgments

Foreword


Chapter 1. Introduction


Metabolic Bone Disease: A Definition


Format of the Book


Chapter 2. The Study of Metabolic Bone Disease in Bioarchaeology


Approaches to the Study of Metabolic Bone Disease


Challenges in the Investigation of Metabolic Bone Disease


Museum Collections


Archaeological Human Bone


Paleopathological Diagnoses


Demographic Issues


Modern Medical Data


Genetics and Anthropology


Cultural and Social Anthropology


Nutritional and Medical Anthropology


Primatology


Conclusions


Chapter 3. Background to Bone Biology and Mineral Metabolism


Bone Tissue: Cortical and Trabecular Bone


Different Types of Bone Structure: Woven Bone and Lamellar Bone


Bone Cells


Modeling and Remodeling: Growth and Adulthood


Mechanisms of Growth


Modeling


Remodeling


Bone Mineralization: The Extracellular Matrix (osteoid)


Tooth Formation and Mineralization


Reasons for Remodeling


Box Feature 3.1. Bone Biology in Context of the Life Course


Bone Biology in Fracture Healing


Mineral Metabolism during Life


Extracellular Mineral Metabolism


Conclusions


Chapter 4. Vitamin C Deficiency Scurvy


Causes of Vitamin C Deficiency


Sources of Vitamin C


Box Feature 4.1. Scurvy and Weaning


The Role of Vitamin C


Vitamin C Requirements


Consequences of Scurvy


Consequences for Adults


Consequences for Children


Scurvy in the Modern Perspective


Anthropological Perspectives


Reference to Probable Scurvy in Early Texts


Box Feature 4.2. Subsistence Change and the Development of Scurvy: The Origins of Agriculture


A More Recent View of Scurvy in the Past


Paleopathological Cases of Scurvy


Diagnosis of Scurvy in Archaeological Bone


Macroscopic Features of Infantile Scurvy


Macroscopic Features of Adult Scurvy


Radiological Features of Infantile Scurvy


Radiological Features of Adult Scurvy


Histological Features of Infantile Scurvy


Histological Features of Adult Scurvy


Differential Diagnosis


Box Feature 4.3. Scurvy in Non-Human Primates: A Result of Human Actions


Conclusions


Appendix: Summary of Published Archaeological Evidence for Vitamin C Deficiency


Chapter 5. Vitamin D Deficiency


The Skeletal Requirement of Vitamin D


Terminology


Causes of Vitamin D Deficiency


Sunlight


Cultural Practices and Sunlight Exposure


Skin Pigmentation and Genetic Adaptations


Food Sources


Pregnancy and Lactation


Increased Age


Age-Related Osteoporosis


Additional Causes of Vitamin D Deficiency with Effects on Mineral Metabolism


Rickets


Consequences of Rickets


Historical Recognition of Rickets


Rickets in the Modern Perspective


Anthropological Perspectives: Rickets


Box Feature 5.1. Beyond Fighting: The Physiological Impact of Warfare


Paleopathological Cases of Rickets


Diagnosis of Rickets in Archaeological Bone


Macroscopic Features of Rickets


Radiological Features of Rickets


Histological Features of Rickets


Residual Rickets in the Anthropological Perspective: Adult Evidence of Childhood Vitamin D Deficiency


Diagnosis of Residual Rickets in Archaeological Bone


Macroscopic Features of Residual Rickets


Radiological Features of Residual Rickets


Histological Features of Rickets


Co-Morbidities


Differential Diagnosis


Vitamin D Deficiency Osteomalacia


Pseudofractures


Adult Vitamin D Deficiency in the Modern Perspective


Box Feature 5.2. Physical and Non-Violent Manifestations of Abuse


Anthropological Perspectives: Osteomalacia


Paleopathological Cases of Osteomalacia


Diagnosis of Osteomalacia in Archaeological Bone


Macroscopic Features of Osteomalacia


Radiological Features of Osteomalacia


Histological Features of Osteomalacia


Conclusions


Appendix: Summary of Published Archaeological Evidence for Vitamin D Deficiency


Chapter 6. Age-Related Bone Loss and Osteoporosis


Definitions of Osteoporosis


Causes of Age-Related Osteoporosis


Menopause


Increased Age


Peak Bone Mass


Mechanical Loading


Extremes of Exercise


Continuing Sub-Periosteal Apposition


Genetics and Population Groups


Nutrition and Lifestyle


Skeletal Features of Age-Related Osteoporosis


Consequences of Age-Related Osteoporosis: Fractures


Distal Radius Fractures (Colles ' Fractures)


Vertebral Fractures


Femoral Fractures


Osteoporosis in the Modern Perspective


Anthropological Perspectives


Box Feature 6.1. Historical and Anthropological Perspectives of Aging


Age-Related Osteoporosis in Men


Box Feature 6.2. Animal Studies in Osteoporosis I: Age-Related Bone Loss


Box Feature 6.3. Problems in the Determination of Age-Related Bone Changes in Biological Anthropology


Paleopathological Cases of Age-Related Osteoporosis


Co-Morbidities


Diagnosis of Age-Related Bone Loss and Osteoporosis in Archaeological Bone


Macroscopic Features of Osteoporosis


Radiological Features of Osteoporosis


Histological Changes of Osteoporosis


Conclusions


Chapter 7. Secondary Osteopenia and Osteoporosis


Causes of Secondary Osteopenia and Osteoporosis


Osteopenia and Mobility


Effects of Immobilization


Box Feature 7.1. Animal Studies in Osteoporosis II: Immobilization-Related Osteopenia


Trauma and Causes of Immobility


Non-Long Bone Trauma and Additional Causes of Disuse Osteoporosis


Bone Loss in Infectious Diseases


Immobility in Viral Conditions


Congenital and Developmental Conditions


Osteopenia in Spinal Cord or Neuromuscular System Afflictions


Box Feature 7.2. Implications of Immobility and Inferences of Disability


Osteopenia in Pathological Conditions


Joint Disease


Hematopoietic Conditions


Neoplastic and Malignant Conditions


The Influence of Diet on Osteoporosis Risk


Dietary Acid Load and Proposed Mechanisms of Bone Loss


Calcium


Protein


Fatty Acids


Fruit and Vegetables


Anthropological Perspectives


Calcium in the Evolutionary Perspective


The Effect of Meat Eating on Calcium Adequacy


Box Feature 7.3. The Health of Adaptive and Transitional Diets: Integrated Approaches?


Calcium Availability with the Onset of Domestication


Diagnosis of Secondary Osteopenia in Archaeological Bone


Conclusions


Chapter 8. Paget's Disease of Bone


POSSIBLE CAUSES OF PAGET'S DISEASE


Box Feature 8.1. Animal Paleopathology


Consequences of Paget's Disease


Pelvic Changes


Cranial Changes


Long Bone Changes


Other Bones that can be Affected


Co-Morbidities


Paget's Disease in the Modern Perspective


Age and Sex


Geographic Variation


Anthropological Perspectives


Paleopathological Cases of Paget's Disease


Diagnosis of Paget's Disease in Archaeological Bone


Macroscopic Features of Paget's Disease


Radiological Features of Paget's Disease


Histological Features of Paget's Disease


Differential Diagnosis


Box Feature 8.2. The Contribution of Paleopathology to Modern Medicine


Conclusions


Chapter 9. Miscellaneous Conditions


Fluorosis


Consequences of Fluorosis


Dental Fluorosis


Skeletal Fluorosis


Co-Morbidities


Fluorosis in the Modern Perspective


Anthropological Perspectives: Fluorosis


Paleopathological Cases of Fluorosis


Other Conditions Linked to Intoxication


Hyperparathyroidism


Causes of Hyperparathyroidism


Primary Hyperparathyroidism


Secondary Hyperparathyroidism


Consequences of Hyperparathyroidism


Anthropological Perspectives: Hyperparathyroidism


Paleopathological Cases of Hyperparathyroidism


Diagnosis of Hyperparathyroidism in Archaeological Bone


Pellagra


Box Feature 9.1. Anthropological Investigations of Displaced Peoples


Starvation


Box Feature 9.2. Malnutrition, Starvation and Osteoporosis


Rare Metabolic Bone Diseases


Hyperostosis


Hypophosphatasia


Osteogenesis Imperfecta


Osteopetrosis


Conclusions


Chapter 10. Overview and Directions for Future Research


Bone Biology


Vitamin C Deficiency, Scurvy


Vitamin D Deficiency, Rickets and Osteomalacia


Age-Related Osteoporosis


Secondary Osteopenia and Osteoporosis


Paget'S Disease of Bone


Miscellaneous Metabolic Bone Diseases


Conclusions


Bibliography


Index