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The Bioarchaeology of Metabolic Bone Disease - 1st Edition - ISBN: 9780123704863, 9780080557915

The Bioarchaeology of Metabolic Bone Disease

1st Edition

Authors: Megan Brickley Rachel Ives
Hardcover ISBN: 9780123704863
eBook ISBN: 9780080557915
Imprint: Academic Press
Published Date: 28th April 2008
Page Count: 350
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The Bioarchaeology of Metabolic Bone Disease provides a comprehensive and invaluable source of information on this important group of diseases. It is an essential guide for those engaged in either basic recording or in-depth research on human remains from archaeological sites. The range of potential tools for investigating metabolic diseases of bone are far greater than for many other conditions, and building on clinical investigations, this book will consider gross, surface features visible using microscopic examination, histological and radiological features of bone, that can be used to help investigate metabolic bone diseases.

Key Features

  • Clear photographs and line drawings illustrate gross, histological and radiological features associated with each of the conditions
  • Covers a range of issues pertinent to the study of metabolic bone disease in archaeological skeletal material, including the problems that frequent co-existence of these conditions in individuals living in the past raises, the preservation of human bone and the impact this has on the ability to suggest a diagnosis of a condition
  • Includes a range of conditions that can lead to osteopenia and osteoporosis, including previous investigations of these conditions in archaeological bone


A wide range of individuals engaged in the study of physical anthropology, paleopathology, medical history and forensic anthropology.

Table of Contents



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



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



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


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


Appendix: Summary of Published Archaeological Evidence for Vitamin C Deficiency

Chapter 5. Vitamin D Deficiency

The Skeletal Requirement of Vitamin D


Causes of Vitamin D Deficiency


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


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


Differential Diagnosis

Vitamin D Deficiency Osteomalacia


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


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


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


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

Macroscopic Features of Osteoporosis

Radiological Features of Osteoporosis

Histological Changes of Osteoporosis


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



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


Chapter 8. Paget’s Disease of Bone


Box Feature 8.1. Animal Paleopathology

Consequences of Paget’s Disease

Pelvic Changes

Cranial Changes

Long Bone Changes

Other Bones that can be Affected


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


Chapter 9. Miscellaneous Conditions


Consequences of Fluorosis

Dental Fluorosis

Skeletal Fluorosis


Fluorosis in the Modern Perspective

Anthropological Perspectives: Fluorosis

Paleopathological Cases of Fluorosis

Other Conditions Linked to Intoxication


Causes of Hyperparathyroidism

Primary Hyperparathyroidism

Secondary Hyperparathyroidism

Consequences of Hyperparathyroidism

Anthropological Perspectives: Hyperparathyroidism

Paleopathological Cases of Hyperparathyroidism

Diagnosis of Hyperparathyroidism in Archaeological Bone


Box Feature 9.1. Anthropological Investigations of Displaced Peoples


Box Feature 9.2. Malnutrition, Starvation and Osteoporosis

Rare Metabolic Bone Diseases



Osteogenesis Imperfecta



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





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© Academic Press 2008
28th April 2008
Academic Press
Hardcover ISBN:
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About the Authors

Megan Brickley

Megan B. Brickley is currently Professor and Tier 1 Canada Research Chair in the Bioarchaeology of Human Disease at the Department of Anthropology, McMaster University, Canada. Her primary research interests are use of paleopathology in bioarchaeology, and interdisciplinary research on past human health and disease. She has served as past-Chair of the British Association of Biological Anthropology and Osteoarchaeology and an Associate Editor of American Journal of Physical Anthropology. Currently she is an Associate Editor of the International Journal of Paleopathology and the President Elect of the Paleopathology Association. Her publications include two co-authored and six edited books and eighty journal papers and book chapters.

Affiliations and Expertise

Professor and Tier 1 Canada Research Chair in the Bioarchaeology of Human Disease at the Department of Anthropology, McMaster University, Canada

Rachel Ives

Dr Rachel Ives is the Curator of Anthropology in the department of Earth Sciences at the Natural History Museum, London. She is responsible for the curation of the palaeoanthropology, fossil primate, human remains, and artefact collections and promotes scientific research, exhibitions, and outreach access to the collections. Rachel’s research interests are in bone cell biology together with skeletal palaeopathology, particularly the metabolic bone diseases and disease co-occurrence. Rachel has carried out large-scale surveys of metabolic bone diseases in urban contexts and was a post-doctoral researcher on a Calleva Foundation funded Child Health project at the NHM, investigating how the skeleton changes during childhood growth and in response to pathology. Rachel previously worked in the commercial sector carrying out archaeological cemetery excavations and osteological analyses, and she continues work in osteoarchaeological consultancy for heritage development projects.

Affiliations and Expertise

Curator of Anthropology, Natural History Museum, London, UK


"[Bioarchaeology of Metabolic Bone Disease] takes us along a fascinating exploratory journey of the main (and not so common) metabolic bone diseases identifiable in skeletal remains. Useful supporting tables, and clear photographic images and line drawings, supplement the text, with a concluding chapter providing a view of future research...." --Professor Charlotte A. Roberts, Department of Archaeology, Durham University

"The authors’ cogent discussion of how elements within a given lifestyle, including diet/nutrition, cultural practices, socio-economic status, and the surrounding environment, can significantly impact the health of individuals and of societies is illustrated with abundant well-chosen anthropological examples. This volume will be of great value to all scholars devoted to accurate, informative reconstructions of past human life." --Mary Lucas Powell, Ph.D., Past Editor, Paleopathology Newsletter, The Paleopathology Association

Ratings and Reviews