Browsing by Author "Walters, Jacklynn"

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    Morphological assessment of disease and metabolic disorders in a Western Cape skeletal population
    (Stellenbosch : Stellenbosch University, 2016-12) Walters, Jacklynn; Greyling, Linda Magdalena; Alblas, Amanda; Stellenbosch University. Faculty of Medicine and Health Sciences (Department of Biomedical Science)
    ENGLISH ABSTRACT : Amongst others, disease, pathology, metabolic disorders and other traits, can be investigated after death by examination of skeletal remains. The evaluation of lesions resulting from disease and metabolic disorders in the Kirsten Skeletal Collection will allow for a better understanding of the effects of disease on skeletal material and of the social development and adaptation of a 20th century population group who, prior to death, inhabited the Western Cape region. The aim of this research was to describe and evaluate the presentation of skeletal pathology resulting from disease and metabolic disorders in the Kirsten Skeletal Collection at Stellenbosch University. A total number of 300 skeletons were studied. The male to female ratio for the study was 2:1, and the majority derived from the mixed population/Cape Coloured group (n=209). Three different examination methods were used in order to identify traits of diseases or disorders on the skeletal material. Macroscopic evaluation of skeletal material was done by examining each skeletal element under a magnifying lamp. Microscopic analysis was done by using dry bone histological techniques to create bone sections which were examined under a light microscope with POL contrast. Lastly, full body x-rays from each skeleton were taken using the Lodox® Statscan® imaging system and radiographs were examined with the help of a musculoskeletal radiologist. Congenital and acquired malformations occurred in 45.7% (n=137) of skeletons. These included sacralisation (11.9%), lumbarisation (7.3%), spina bifida (14.0%), scoliosis (4.7%), kyphosis (17.0%), and spondylolysis (2.7%). Infectious diseases presented mostly as a periosteal reaction on skeletal elements. Visually recognisable periostitis occurred in 60.7% of skeletons with 29.3% of skeletons showing visceral periosteal rib lesions. Metabolic disorders were observed in 72.0% of skeletons and included porotic hyperostosis (10.7%), cribra orbitalia (35.6%), enamel hypoplasia (43.8%), Harris lines (24.3%) and osteoporosis (41.3%). The males in the study population showed a statistically significantly higher prevalence for cribra orbitalia than the females. Signs observed for degenerative bone disease included vertebral osteophytes (81.0%), peripheral osteophytes (43.0%), Schmorl’s nodes (9.3%), and diffuse idiopathic skeletal hyperostosis (5.7%). Neoplasms were observed in 23.3% of the skeletons examined and included primary benign bone tumours (17.7%), primary malignant bone tumours (1.0%), and secondary skeletal metastases (5.3%). Neoplasms observed showed a similar prevalence as previous studies. Paget’s disease occurred in four skeletons. An important finding in the present study was the high prevalence of periostitis in the mixed population group which was ascribed to a variety of factors including unsanitary living environments, malnutrition, alcohol abuse and lack of effective medical treatment. Pulmonary infections such as tuberculosis (TB) contributed to a high prevalence of visceral rib lesions; however, this study did not find visceral rib lesions to be pathognomonic of TB. The present study also showed metabolic disorders indicating periods of stress throughout life such as malnutrition and infectious diseases. Results on cribra orbitalia (males affected more than females) contradicted previous literature and the iron deficiency anaemia theory, suggesting that other factors contributed to the presentation of cribra orbitalia. To the author’s best knowledge, this was the first in depth study using a combination of three different methods to evaluate disease presentation of a skeletal collection representative of the inhabitants of the Western Cape, therefore, giving a unique interpretation of the health status of this population.