jessica skinner university of wisconsin-milwaukee 80 th annual meeting of the society for american...
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Entheses and Activities: The Effects of Entheseal Change for Individuals
from the Milwaukee County Institution Grounds Population
Jessica SkinnerUniversity of Wisconsin-Milwaukee
80th Annual Meeting of the Society for American Archaeology, San Francisco, 15-19 April 2015.
Symposium: People that no one had use for, had nothing to give to, no place to offer: The Milwaukee County Institution Grounds Poor Farm Cemetery
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This study aimed to further the work of representing and contextualizing the life experiences of those interred in the cemetery through entheseal change analysis using a replicable non-metric scoring method and 3D geometric morphometric analysis. In addition this project validated a multi-factorial approach to understanding osteological change through the insertion sites of the primary rotator cuff muscles.
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A crew digging a trench and laying drain tile. Date Unknown. (Courtesy of the Wisconsin Historical Society)
Osteological Change and Life Lived
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Features of Osteological Change
(Boyl and Kim 2011)
“Comparison of the trabecular architecture of the human proximal femur between (a): Wolff’s original analytical trajectory (Wolff, 1892,1986), (b) A natural proximal femur radiograph (Skedros and Baucom, 2007), and (c) A simulated radiograph based on the final computational results.” (Boyl and Kim 2011)
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Direct attachmentAttach to long
bone diaphysesCranial ElementsVertebrae
Fibrous Fibrocartilagino
us
Attach in four zones
Attach to long bone epiphyses
Some short bonesSome areas of the
Vertebrae
(Villotte 2012:3).
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The Structure of Entheses
Entheseal Structure at the Calcaneal tendon insertion. (Paxton 2014)
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Histological Zones of Fibrocartilaginous Entheses
(Supraspinatus Insertion Prepared Slide: Adapted from Benjamin et al., 1986)
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Enthesitis observed on the talus and calcaneus using X-ray and MRI (Haibel and Sieper 2015)
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A 25 year old male with ankylosing spondylitis. A 1.5 T whole-body MRI coronal STIR illustrates subcoracoid (noted with arrows) and effusion in the acetabulum (noted by points). This study provides evidence of enthesitis presenting in conjunction with ankylosing spondylitis.
(Eshed, e al 2007)
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The Location of the Milwaukee County Poor Farm Cemetery
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Life at the Milwaukee County Grounds
The Milwaukee County Almshouse, Circa 1917(Courtesy of the Wisconsin Historical Society)
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Life at the Milwaukee County Grounds
Above, residents of the County Home For Dependent Children, 1912 (Courtesy of the Milwaukee County Historical Society)
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Sample40 Individuals Selected.Osteologically estimated sex for each is male.Osteologically estimated ages range 30-55+The left humerus is the preferred standard.
Data CollectionEntheseal Change Assessment based on
Henderson and Villotte (2012). Geometric Morphometric landmarks collected
using MicroscribeG2 3D digitizer.3D Geometric Morphometric landmarks
analyzed using Geomorph, a package in R.
Study Design
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Standardized sex estimation methods from Buikstra and Ubelaker (1994), Phenis(1969) and White(2012), as well as metric assessment methods from Steele(1978), Spradley and Jantz (2011), and Stewart (1979)
Mean age estimated using standardized methods from Brooks and Suchey (1990), Osborne et al (2004), and Buikstra and Ubelaker (1994).
Standardized Osteopathology Methods: Ortner (2003, 2012), Larsen (1997), White (2014), Mewre (2010), Mays (1996), and Waldron (2006).
Age, Sex, and Pathology Assessment
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The Primary Rotator Cuff Muscles
o Subscapulariso Supraspinatuso Infraspinatuso Teres Minor
o Each muscle inserts at an acute angle to attachment sites on the proximal humerus
o This acute angle attachment provides stability to the shallow glenohumeral joint.
o This joint in particular provides a large range of motion but is highly susceptible to stress.
Infraspinatus
Tere
s Min
or
Supraspinatus
Subscapularis
atus
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Consistent with these methods, the contour opposite the acute angle at which the fibers attach as well as the other areas of the surface and margin of the enthesis were observed.
Features observed on the entheses were scored through a 2 and 3 point degree of expression method and included bone formation, erosions, which are “depressions or excavations involving discontinuity of the cortex”(Henderson et al 2012), pores, and cavitations.
This scale and the entheses examined are delineated on the tables in Table 1.
Entheseal Change Assessment
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Zone 1Margin opposite acute angle of
fiber attachment
Bone Formation BF (Z1) 1 = Small, nodular or slightly raised margin < 1mm 2 = Distinctive sharp crests or other enthesophytes. ≥ 1mm but < 50% of margin 3 = Distinctive sharp crests or other enthesophytes ≥ 1mm but ≥ 50% of margin
Erosion ER (Z1)Depressions or
excavations of any shape and involving
discontinuity of the cortex generally greater in width than depth with
irregular margins. Only erosions >2
mm were recorded
1 = < 25% of margin2 = 25 to 50% of margin3 = > 50% of margin
Scoring methods
(Feature, Porosity, Bone Formation, and Cavitation
Scoring Table adapted from Henderson 2010)
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Scoring MethodsZone 2 Bone Formation BF
1=”Roughness/rugosity, change is diffuse, not a distinct structure 2= distinct structure measuring >1mm, affecting < 50% of the surface. 3= distinct structure measuring > 1mm, affecting ≥ 50% of surface
Remaining Margin Erosion ERDepressions or
excavations of any shape and involving
discontinuity of the cortex generally greater in width than depth with irregular margins. Only erosions >2 mm were
recorded
1 = < 25% of surface2 = 25 to 50% of surface3 = > 50% of surface
And Surface Fine Porosity ≥ 1mm FPOSmall, round to oval
perforations with smooth, rounded margins
≤1 mm
1 = < 50% of margin2 = > 50% of margin
Macro-Porosity MPOSmall, round to oval
perforations with smooth, rounded margins
>1 mm
1 = one or two pores2 = > 2 pores
Cavitation CASubcortical cavity with an external opening smaller than the maximum diameter of the cavity
1 = one cavitation2 = two or more cavitations (Adapted from Henderson 2010)
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(Adapted from Henderson 2010)
Zones and feature designation of Entheseal Change Scoring
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Digitizing with theMicroscribe G2
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Three Dimensional Rendering of Left Subscapularis
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The effect of Age
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The effect of Age
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Morphometric Shape Changes
Subscapularis landmark shape associated with A) Low Entheseal Change Scores B) High entheseal change scores
A) B)
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The effect of Pathology
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The effect of Pathology
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Dr. Patricia RichardsDr. J. Patrick GrayPeter KilloranCatherine JonesShannon FreireBrianne CharlesAdrienne Frie Brooke DrewNick Richards
Thank you to all who made this presentation possible.
Dr. Fred AnapolDr. John RichardsArt AndersenEmily Epstein Alexis JordanDavid StrangeHelen WernerEric BurantThe Wisconsin
Historical Society
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Thank you.
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Adams, D.C. & Otárola-Castillo, E 2013 Geomorph: an R package for the collection and analysis of geometric morphometric shape data. Methods in Ecology and Evolution. 4:4:393-399.
Arias‐Martorell, J., Potau, J.M., Bello‐Hellegouarch, G., Pastor, J.F. & Pérez‐Pérez, A. 2012 3D geometric morphometric analysis of the proximal epiphysis of the hominoid humerus. Journal of anatomy. 221: 5:394-405.
Brown, E.G.
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