The Diagnostic Implications of Two Cases of Known Rheumatoid Arthritis from the CAL Milano Cemetery Skeletal Collection
Corresponding Author
Lucie Biehler-Gomez M.S.
LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Via Mangiagalli 37, Milan, 20133 Italy
Additional information and reprint requests:
Lucie Biehler-Gomez, B.Sc., M.S.
LABANOF, Laboratorio di Antropologia e Odontologia Forense Sezione di Medicina Legale
Dipartimento di Scienze Biomediche per la Salute
Università degli Studi di Milano
Via Mangiagalli 37
20133 Milan
Italy
E-mail: [email protected]
Search for more papers by this authorCristina Cattaneo M.D., Ph.D.
LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Via Mangiagalli 37, Milan, 20133 Italy
Search for more papers by this authorCorresponding Author
Lucie Biehler-Gomez M.S.
LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Via Mangiagalli 37, Milan, 20133 Italy
Additional information and reprint requests:
Lucie Biehler-Gomez, B.Sc., M.S.
LABANOF, Laboratorio di Antropologia e Odontologia Forense Sezione di Medicina Legale
Dipartimento di Scienze Biomediche per la Salute
Università degli Studi di Milano
Via Mangiagalli 37
20133 Milan
Italy
E-mail: [email protected]
Search for more papers by this authorCristina Cattaneo M.D., Ph.D.
LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Via Mangiagalli 37, Milan, 20133 Italy
Search for more papers by this authorAbstract
Rheumatoid arthritis (RA) is the most common erosive arthropathy and is of particular interest to forensic sciences. However, its diagnosis on bones remains challenging. We examined two skeletons from the CAL Milano Cemetery Skeletal Collection diagnosed with the pathology during life, to test the validity of the diagnostic criteria on bones. The first showed typical lesions of RA described in the literature. The second exhibited secondary osteoarthrosis, suggesting long-standing RA. A differential diagnosis including all four seronegative spondyloarthropathies, erosive osteoarthritis, gout and neuropathic arthropathy was also considered. Both shared common features consistent with the literature: symmetric erosions of bones in the hands, wrists and elbows, sparing of the distal interphalangeal joints, and the absence of sacroiliac and spinal fusion. Given the paucity of studies on known RA skeletons, these results strengthen the criteria for diagnosis. This research is, to our knowledge, the first study on identified and known individuals with RA.
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