Tuberculosis in the Americas: Current perspectives • 169 



T4 shows a small focal resorption on right side of body, with 

 epiphyseal ring gone. Body height loss, leading to scoliosis, appar- 

 ent. 



T5/T6: circumferential porosity and remodeling on both bodies. 



T7: erosive circumferential lesions, mostly small (ca. 2-3 mm) 

 foci. Slightly larger resorptive areas occur within neural canal, 

 extending onto pedicles. This is the only pedicle involvement ob- 

 served in M6-102la. 



T8 shows a central lesion with the main opening inferiorly di- 

 rected, although a superior perforation also occurs. Multilocular 

 sclerotic cmargination. 



T9-T10 fused through bodies only, with disk space gone. Ero- 

 sive circumferential remodeling on each body. 



Til: circumferential erosion present with one resorptive focus at 

 midline. 



TI2 relatively intact. 



L1-L4 ankylosed kyphosed mass, fused through neural arches. 

 Body of L3 entirely gone, with a few residual osteophytes. A lesion 

 was observed in bixiy of LI , in addition to circumferential erosion 

 under anterior longitudinal ligament. L1-L2 fused through arch 

 only, as are L3-L4. L4 has massive erosive area under anterior 

 longitudinal ligament. 



L5 fused to sacrum. Extensive zygapophysial arthritis is probably 

 a secondary result of disease process. 



M6-1025: 5.5-7.5 months. Main involvement is in right hip. Ero- 

 sion of acetabulum with onion-skin proliferation extending over all 

 of internal and external surfaces. Right femur shows heavy re- 

 modeling in area of greater trochanter that extends to linea aspera. 

 Unfortunately, this region is poorly preserved. 



M6-1 183a: Male 35-39 years. L5 and SI are affected. L5 shows 

 evidence of an active disease process eroding inferior surface of 

 body. Sclerotic reaction clearly present, with bony reactive pro- 

 cesses active at time of death. Trabeeulae coarsened. Neural arches, 

 i.e., zygapophysis, affected by osteoarthritic change secondary to 

 disease. SI presents a complementary lesion pattern. 



M6-1 183b: Male 50+ . Remodeling observed on interhal aspects of 

 ribs. Surface well integrated: costal groove obliterated. 



M6-I2I5: 12-15 years. Remodeling evident at sternal ends of ribs. 



M6-I223: 5-7 months. An infant with fiberbone periostitis begin- 

 ning to develop on internal aspects of both ilia, r > I. Long bones 

 show evidence of periosteal remodeling. Both internal and external 

 surfaces of cranial vault are slightly porous. 



M6-1557: Sex unknown, adult. Periostitis observed on internal as- 

 pect of ribs. 



M6-l6IOa: Male 45-50 years. Periostitis observed on internal as- 

 pect of ribs. 



M6- 1616a: Male 35-45 years. Internal surface of ribs shows evi- 

 dence of integrated periosteal reaction. 



M6-2256a: Male 30-40 years. 9th and 10th thoracic elements are 

 affected. This may be an ostcomyclitic process since no other vcr 

 tebrae are affected, but will include it as a possible example of 

 tuberculosis. 



Zagreb Paleopathology Symp. 1988 



T9: much of body destroyed by disease process. Superficial new 

 bone formation is present. Only approximately 2/3 of superior sur- 

 face is intact, as is right side. Superficial remodeling present on 

 external aspect of vertebral body. Sclerotic reaction of trabeeulae 

 bone has smoothed interior "surface," although two oval reaction 

 area remnants remain. 



TIO: body height maintained on left side. Sclerotic emargination 

 of oval lesions evident in body. 



Kyphosis due to complementary destruction of these two ver- 

 tebrae could have led to an acute angulation of as much as 30°. 



M6-2279b: Male 20-21 years. L5 (only lumbar vertebra fully ob- 

 servable) shows extensive remodeling on superior surface of body 

 and multiloculated lesions. Body height reduced. Lesions extend 

 into pedicles. Other lumbar fragments suggest no additional units 

 affected. 



M6-2297a: Male 27-30 years. Involvement of T9-T1 1 which pres- 

 ent multiloculated erosive areas. No loss of vertebral body height, 

 no arch involvement. Destructive foci extending across disk space 

 apparent at levels of T9-TI0, TIO-Tl I . Sclerotic cmargination of 

 resorptive regions is characteristic. 



M6-2330: 1-2 years. Inferior surfaces of centra of two lumbar 

 vertebrae present extensive remodeling and multiple small, 

 coalesced resorptive areas. In addition, sternal extremity of three 

 left ribs present expansive periosteal remodeling. 



M6-3l98a: Male 20-21 years. L5 (only lumbar vertebra fully ob- 

 servable) shows extensive remodeling on superior surface of body. 

 Multiloculated lesions apparent, and extend into pedicles. Body 

 height diminished. Other lumbar fragments suggest no additional 

 units affected. 



M6-3205: Male 27-30 years. Periostitis observed in internal aspect 

 of ribs. 



M6-3215: Male 25-30 years. Heavily remodeled spinal column 

 and lower portion of body. Long bones porous , with some periosteal 

 reaction. Weight-bearing joint surfaces somewhat porous. Tarsals in 

 general are light in weight, and appear expanded and porous. Meta- 

 tarsal bodies show periostitic reaction. Auricular surface of right 

 innominate heavily eroded, with some sclerotic emargination. 

 Remnants of oval lesions evident. 



Circumferential remodeling evident on T3-TI 1 . T4 shows some 

 porosity that may be post mortem. Part of inferior body has col- 

 lapsed into internal lesion. Sclerotic emargination is obvious. 



T7: anterior portion of body eroded and absent. 



T8: left side of body eroded and absent. Focal lesions evident, as 

 is sclerotic emargination. 



T9: 1.8 X 1 .3 cm resorptive space present on right side of body. 

 This feature leads into internal, smaller focal resorption. Body has 

 collapsed with little proliferative reaction. 



Ribs: at least three left and five right show expansion on internal 

 aspect of neck. Proliferative reaction has added up to 2 mm of new 

 bone. Both sclerotic and active fiberbone reaction is evident from 

 mid to lower thorax. These bodies are expanded internally such thai 

 costal grooves are indistinct. 



M6-324Ha: Female 25-26 years. Evidence of remodeled perio,stitis 

 on internal aspect of ribs. 



