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Four cases of ankylosing spondylitis in medieval skeletal series from Croatia

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Abstract

Osteological changes consistent with ankylosing spondylitis were observed in three males and one female skeleton recovered from four medieval sites—Velim, Koprivno, Buje, and Rijeka—all situated on Croatia’s eastern Adriatic coast and its immediate hinterland. The skeletons present changes in the spine, ribs, sacrum, and innominates that are typical of ankylosing spondylitis that is a progressive, inflammatory disease of connective tissue calcification. The disease most commonly affects the sacroiliac joints, the joints of the spine, and the costovertebral joints. In the final stages of the disease, the vertebral bodies remodel and together with the associated syndesmophytes form a continuous, smooth bone surface that is sometimes referred to as “bamboo spine.” The prevalence of this disorder in the analyzed Croatian samples is 4/303 or 1.3% and thus corresponds with frequencies recorded in modern European populations. Differential diagnosis rules out the possibility of DISH, rheumatoid arthritis, and melorheostosis. These are the first cases of ankylosing spondylitis identified in Croatian archaeological series.

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Acknowledgments

The authors would like to thank the Editor-in-Chief of Rheumatology International, Ernst-Martin Lemmel, and the anonymous reviewers for constructive suggestions and comments that substantially improved the manuscript. This study was financially supported by a grant from the Ministry of Science, Education and Sports of the Republic of Croatia (Grant number 101–197–0677–0670).

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Archaeology, Croatian Academy of Sciences and Arts, Ante Kovačića 5, 10 000, Zagreb, Croatia

    Mario Šlaus & Mario Novak

  2. Department of Diagnostic and Interventional Radiology, Dubrava University Hospital, Zagreb, Croatia

    Mislav Čavka

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  1. Mario Šlaus
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  2. Mario Novak
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  3. Mislav Čavka
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Correspondence to Mario Novak.

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Šlaus, M., Novak, M. & Čavka, M. Four cases of ankylosing spondylitis in medieval skeletal series from Croatia. Rheumatol Int 32, 3985–3992 (2012). https://doi.org/10.1007/s00296-011-2343-7

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  • DOI: https://doi.org/10.1007/s00296-011-2343-7

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