Recognition of hypertrophic osteoarthropathy in skeletal remains.

OBJECTIVE: To characterize hypertrophic osteoarthropathy (HOA) in skeletons to allow its recognition in the archeologic record.

METHODS: Individuals diagnosed in life with diseases known to cause HOA were examined from the Hamman-Todd, Grant, and Terry human skeletal collections. The latter consist of 5142 individuals who died in the early part of this century. A "control" group was obtained by examination of 100 (consecutive, exclusive of HOA related disorders) additional individuals from the Terry Collection, which were accompanied by diagnoses not known to be associated with HOA. Sixty individuals documented with skeletal evidence of syphilis (from the Hamman-Todd Collection) and 73 individuals documented as having skeletal evidence of yaws (from the Ward Site, 4300 ybp) were examined as comparison treponemal disease-derived, periosteal reaction-afflicted populations.

RESULTS: In total, 319 individuals were identified with HOA. HOA was recognized as a disorder of distal diaphyseal or diffuse periosteal reaction. Proximally-limited disease virtually eliminates the diagnosis.

CONCLUSION: HOA is recognizable as a population phenomenon suggestive, when found in the archeologic record, of underlying chronic pulmonary disease.