The Bioarchaeology of Metabolic Bone Disease

The Bioarchaeology of Metabolic Bone Disease

1st Edition - April 28, 2008

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  • Authors: Megan Brickley, Rachel Ives
  • eBook ISBN: 9780080557915

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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

  • Acknowledgments


    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




Product details

  • No. of pages: 350
  • Language: English
  • Copyright: © Academic Press 2008
  • Published: April 28, 2008
  • Imprint: Academic Press
  • eBook ISBN: 9780080557915

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

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