Chapter 10. Differential Diagnosis of Skeletal Lesions in Infectious Disease

  1. Ron Pinhasi PhD Lecturer in Prehistoric Archaeology member2 and
  2. Simon Mays PhD Human Skeletal Biologist Visiting Lecturer member Secretary3
  1. Donald J. Ortner PhD, DSc biological anthropologist Visiting Professor chairman acting director president member

Published Online: 27 DEC 2007

DOI: 10.1002/9780470724187.ch10

Advances in Human Palaeopathology

Advances in Human Palaeopathology

How to Cite

Ortner, D. J. (2007) Differential Diagnosis of Skeletal Lesions in Infectious Disease, in Advances in Human Palaeopathology (eds R. Pinhasi and S. Mays), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470724187.ch10

Editor Information

  1. 2

    Department of Archaeology, University College Cork, Cork, Ireland

  2. 3

    English Heritage Centre for Archaeology, Fort Cumberland, Eastney, Portsmouth PO4 9LD, UK

Author Information

  1. Department of Anthropology, National Museum of Natural History, Smithsonian Institution, Washington, DC 20560, USA

Publication History

  1. Published Online: 27 DEC 2007
  2. Published Print: 14 DEC 2007

ISBN Information

Print ISBN: 9780470036020

Online ISBN: 9780470724187



  • infection;
  • pathogen;
  • skeleton;
  • abnormalities;
  • diagnosis


Without doubt infectious pathogens have been an important challenge for hominines throughout the evolutionary process. With the advent of major changes in the relationship between Homo sapiens and the environment that occurred in the Holocene, it is highly likely that the effect of pathogens became more serious. This is both because of an increased number of organisms pathogenic to humans and because of the increased exposure to infectious pathogens that inevitably came with animal domestication and greater population density associated with agriculture, sedentary human societies and urbanism.

Exploring the significance of infection in past human societies is a challenging exercise in which multiple lines of evidence must be exploited. One of these is the evidence of infectious disease that is present in archaeological human skeletal populations. One of the limitations of this evidence is that most of the infectious diseases that cause severe morbidity and mortality are acute diseases and rarely affect the skeleton. Some of the more chronic infectious diseases can affect the skeleton, but most individuals with these diseases will not have skeletal involvement. Nevertheless, the presence of these diseases in archaeological human skeletal samples provides at least some evidence regarding the health of past populations. The quality of these data depends on the accuracy with which observations about the prevalence of infectious disease in skeletal samples are made.

The objective of this chapter is to provide the reader with a brief summary of the most typical skeletal manifestations of the infectious pathogens that most often cause disease in human groups and which also can be identified in at least some cases in human skeletal remains.