Donald J. Ortner’s research while affiliated with Smithsonian Institution and other places

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Publications (50)


Anemia or scurvy: A pilot study on differential diagnosis of porous and hyperostotic lesions using differential cranial vault thickness in subadult humans
  • Article

June 2014

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218 Reads

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60 Citations

International Journal of Paleopathology

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Evan M. Garofalo

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Donald J. Ortner

Metabolic disorders, such as scurvy, manifested in human skeletal remains provide insight into health, nutrition, and environmental quality in past populations. Porous cranial vault lesions are often used to diagnose metabolic conditions in subadult remains, but overlapping gross lesion expressions have led to over-diagnosis of anemia and under-diagnosis of scurvy. Studies by Ortner and colleagues have suggested that specific porous cranial lesions are pathognomonic of scurvy, but additional diagnostic tools are necessary. In this technical report, we offer a preliminary assessment of cranial vault thickness (CVT) at the site of porous lesions (sensu lato porotic hyperostosis, cribra orbitalia) as a method for distinguishing between scurvy and anemia in subadult crania. Computed Tomography (CT) was used to measure CVT at various landmarks associated with porotic hyperostosis and cribra orbitalia, complemented by lesion scores, from scorbutic (N = 11), anemic (N = 3), and non-pathological (N = 28) subadult crania used as a control group. Results indicate that CVT consistently distinguishes scorbutic from non-pathological individuals, while anemic individuals overlap with both – likely a function of small sample size in this study. Despite current limitations, CVT has the potential to be an objective diagnostic tool for distinguishing scurvy and expanding reconstructions of nutritional adequacy over the life course in past populations.


Treponemal infection in Peru's Early Colonial period: A case of complex lesion patterning and unusual funerary treatment

March 2014

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60 Reads

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19 Citations

International Journal of Paleopathology

This study describes a series of skeletal lesions observed in a mid 16th century individual of an old adult female from the Early Colonial Period of northern coastal Peru. This fragmented skeleton revealed evidence of complex, active, and systemic chronic infection that included multiple pathological foci on the cranial vault, extensive pathological new bone formation in both arms, the sternum, ribs, left scapula, clavicles, femora, and fibulae, which was paralleled by extensive endosteal obliteration of affected long bone medullary cavities. Differential diagnosis included hematogenous osteomyelitis, Paget's disease, fluorosis, melorheostosis, endosteal hyperostosis, and hypertrophic osteoarthropathy. Simultaneous periosteal and endosteal bone deposition of the clavicles, in addition to patterns of florid bone deposition on long bones and superficial cavitation, point most directly to treponemal disease. Co-morbidity with a non-specified respiratory disease and well-healed fractures of the tibiae are also considered. We also relate this person's illness to the highly informal disposal of their body to underscore how social perceptions of disease may have shaped this unusual and informal funerary ritual. Ultimately, this research cautions against overly “tibia-centric” thinking regarding treponemal syndromes, raises questions regarding the history and nature of treponemal disease in Peru, and highlights cross-disciplinary connections between paleopathology and mortuary archaeology.


Skeletal Manifestations of Skin Ulcer in the Lower Leg

May 2013

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118 Reads

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23 Citations

International Journal of Osteoarchaeology

Skin ulcers of the lower leg are known to cause both destructive and, more commonly, bone‐forming lesions. Typically, bone‐forming lesions in this disorder have clearly defined margins although there may be extensive reactive bone formation involving much or all of the adjacent diaphysis. These lesions are best described in patients from tropical areas, and in these environmental contexts, these are known as tropical ulcers, but leg ulcers can be caused by a variety of diseases and conditions, of which vascular insufficiency plays an important role among the elderly. The lesions are important clinically because of the disability associated with the ulcer and because of complications that can develop including osteomyelitis and cancer. In most cases, the bone lesions caused by ulcer are easily diagnosed in archaeological human skeletal remains and provide some insight into the prevalence of this disorder in antiquity. In this paper, we review the gross and radiological manifestations of bone lesions resulting from overlying skin ulcer in tibiae of 13 cases including archaeological and modern medically documented skeletons. In two of the cases, there is medical documentation regarding the presence of a chronic ulcer on the lower leg. The objectives of this paper were to explore the diversity of bone lesions associated with ulcers of the tibia and to provide an improved basis for the diagnosis of this disorder in human skeletal remains. Copyright © 2011 John Wiley & Sons, Ltd.



FIGURE 69.1: Participants in the Smithsonian Institution course on paleopathology held in 1985: 1. Rose A. Tyson, 2. Gillian Stroud, 3.Dale McCall, 4.Leslie Eisenberg, 5. Jose Manuel Reverte, 6. Anna Siniarska, 7. Takao Suzuki, 8. Catryn Power, 9. Denise Hodges, 10. Ethne Barnes, 11. Nancy C. Lovell, 12. Roberto Macchiarelli, 13. Charlotte A. Roberts, 14. Valerie Higgins, 15. Dominique Modesti, 16. Patricia Miller-Shaivitz, 17. Keith Dobney, 18. Kathy Gruspier, 19. Marek Zvelebil, 20. Howard Duncan, 21. Stephen L. Whittington, 22. P. Stuart-Macadam, 23. M. Pamela Bumsted, 24. Donald J. Ortner, 25. M. R. Kudabaux, 26. Joe Zias. Participants not pictured are Roxie Walker and Mary Lucas Powell. (Source: NMNH.)  
Special Courses in Human Skeletal Paleopathology
  • Chapter
  • Full-text available

June 2012

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753 Reads

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2 Citations

Download

Bone Reactions on a Pliocene Cetacean Rib Indicate Short-Term Survival of Predation Event

May 2012

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205 Reads

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27 Citations

International Journal of Osteoarchaeology

There is little osteological evidence of non‐lethal predation events in the archaeological or vertebrate paleontological record. A small section of Pliocene cetacean rib collected from the Yorktown Formation within the PCS Phosphate Mine (formerly Lee Creek Mine), Aurora, North Carolina, U.S.A., shows evidence of this kind of trophic interaction. In this case study, we offer a diagnosis of bone traumatic pathology in which three bone‐forming lesions on the partial rib are interpreted as the reaction to a bite inflicted by a macro‐predator, the first such report from a marine environment. In addition to the three well‐defined lesions, a thin layer of woven bone covers much of the remaining cortical bone. The combination of the three bone‐forming lesions and the thin layer of woven bone suggest the presence of an inflammatory process almost certainly caused by infection secondary to the trauma. Survival following the traumatic event was probably less than 6 weeks. The Neogene chondrichthyan fauna from this locality preserves several large predators, including Carcharocles megalodon, Carcharodon carcharias, Isurus xiphidon and Parotodus benedeni, which were all capable, at least in terms of their size, of having bitten the cetacean. Although most of the odontocetes known from the Yorktown Formation were too small to have inflicted this wound, some of the physeterids may have been large enough to have caused the lesions on the partial rib. This evidence of predation in Pliocene whale bone raises the possibility of similar lesions being found in whale bone recovered from archaeological sites. Copyright © 2010 John Wiley & Sons, Ltd.


Figure 1. Diagrams showing surviving skeletal elements and the distribution of metastases and the major lesions. 
Figure 2. Lytic foci in left scapula adjacent to the glenoid fossa. The lesions penetrate the outer cortex as clusters of pores through cortical bone and vary in size from approximately half a millimetre to two millimetres. They are surrounded by new bone formation. This figure is available in colour at www.interscience. wiley.com/journal/oa 
Figure 6. Close-up of radiograph of abnormal regions in the left ribs 4–7. A large sunburst lesion is present on the centre of the shaft of the seventh left rib, covering 70% of the shaft. A smaller area of spiculated woven bone formation is present on the neck of the sixth rib. 
Figure 8. Axial CT scan of cranium. This displays widespread abnormality within the diploe  ̈ , characterised by lesions of reduced density with poorly defined margins. There are other areas of increased density. 
Multicentric osteosarcoma associated with DISH, in a 19th Century burial from England.

March 2012

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329 Reads

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8 Citations

International Journal of Osteoarchaeology

Osteosarcoma is a rare type of malignant neoplasm that is most frequent in adolescents and young adults although it can develop at any age. It can metastasize from a primary site in bone to other bones and soft tissues. Usually the disorder causes a single bone-forming lesion (unicentric) but some cases have multicentric, bone-forming lesions. Some of these lesions develop at different sites at different times. In a second variant of multicentric osteosarcoma, synchronous bone-forming lesions develop at multiple sites. Distinguishing between these two types of multicentric osteosarcoma is challenging in a clinical context and the criteria for doing so are unlikely to be met in an archaeological burial. Wolverhampton burial HB 39 was excavated from an early-nineteenth century cemetery site in England. It consists of the incomplete skeleton of an adult male of at least 45 years of age with multicentric osteosarcoma. The individual represented by this burial also had diffuse idiopathic skeletal hyperostosis (DISH). Three of the bone-forming lesions associated with osteosarcoma developed on the bony outgrowths related to DISH.


Juvenile cases of skeletal tuberculosis from the Terry Anatomical Collection (Smithsonian Institution, Washington, D.C., USA)

January 2012

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2,741 Reads

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53 Citations

Acta Biologica Szegediensis

A B S T R A C T In order to better define the variability of skeletal expression of tuberculosis, we studied 1728 skeletons from the Terry Anatomical Collection, Smitsonian Institution, dating from the first half of the 20th century. Among the numerous cases we studied there were three juvenile individuals who died from TB that are of particular interest. The spine of the first case exhibits lesions related to a multifocal cystic spondylitis, associated with rib lesions probably caused by a pneumo-pleural infection. The second skeleton has frontal and parietal endocranial lesions that can be attributed to TB meningitis. The associated multifocal vertebral and costal abnormalities apparent in this case may represent an early stage in the development of skeletal TB lesions. The skull vault of the third skeleton is perforated by lytic lesions compatible with a diagnosis of cranial tuberculosis. These lesions are associated with bone forming endocranial lesions that suggest TB meningitis. The postcranial skeleton shows mainly osteolytic lesions. These case-studies give an insight to different manifestations of skeletal TB and provide stronger basis for identifying this infection in archaeological human remains. The three juvenile skeletons from the Terry Anatomical Collection provide evidence that lesions like endocranial symptoms, vertebral hypervascularization, rib periostitis, diffuse periostitis of long bones and especially their association do have diagnostical value in the identification of tuberculosis.



What skeletons tell us. The story of human paleopathology

July 2011

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193 Reads

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38 Citations

Virchows Archiv

Human skeletal paleopathology provides important insight regarding the antiquity of some diseases and their distribution in past human groups. The history of human skeletal paleopathology extends back more than 150 years. Rudolf Virchow published reports on the subject, and research on paleopathology has provided critical data on important topics such as the origin of syphilis. With the development of powerful new research tools, human paleopathology will continue to be a source of data on the development of disease and its effect on human biological and cultural development.


Citations (39)


... The relatively fine ceramics found as grave goods in the tombs and the sheer number of work hours required to dig the sophisticated tombs, as well as the allure of a nearby permanent water source, may indicate greater sedentism by some members of the group. While it can be argued that secondary burial in a common location is a documented pattern for nomadic groups, Donald Ortner and Bruno Frohlich (Ortner and Frohlich 2011) counter that the same has been seen in sedentary groups. ...

Reference:

Bioarchaeological reconstruction of group identity at early bronze: Age bab edh-dhra‘, jordan
The EB IA People of Bâb edh-Dhrâʿ, Jordan
  • Citing Chapter
  • July 2011

... A vitamin C deficiency is historically endemic to the northern and temperate climates at the end of winter. Vitamin C is abundant in fresh fruit and vegetables and in small amounts in uncooked meat and intestines (Ortner/Theobald 2000). So, if the Pomors indeed brought the cloudberries it is possible that they had knowledge of scurvy and knew how to prevent themselves from getting it. ...

Paleopathological Evidence of Malnutrition
  • Citing Chapter
  • December 2000

... Tuberculosis is generally considered to be one of the most ancient diseases of the genus Homo (Johnston, 1999;Ortner & Theobald, 1999). Recent studies on the genome of the bacteria of the Mycobacterium tuberculosis complex (MTBC), including M. tuberculosis, M. bovis, M. africanum, M. canettii and M. microti, confirm the ancient origin of the tubercle bacillus estimated at 30 000-35 000 years BC (Brosch et al., 2002). ...

Diseases in the Pre-Roman World
  • Citing Chapter
  • January 1993

... There is limited historical, paleopathological and biomolecular evidence of brucellosis in human archaeological remains (Bendrey et al., 2020;Ortner, 2003;Roberts and Buikstra, 2019). The few examples of published macroscopically-based differential diagnoses of brucellosis in Eurasia also span a wide timeframe, 3700 BCE to 1500 CE (e.g., Brothwell, 1965;Capasso, 1999;Etxeberria, 1994;Hodgkins, 2002;Rashidi, 2001). The limited presence of macroscopically diagnosed brucellosis in the past is surprising, given the frequency of osteoarticular changes associated with contemporary cases (Geyik et al., 2002;Roberts and Buikstra, 2019). ...

Brucellosis in early Bronze Age Jordan and Bahrain: An analysis of possible cases of Brucella spondylitis
  • Citing Article
  • January 2001

American Journal of Physical Anthropology

... Integral to the use of this weighted scoring is the provision of specific diagnostic training for researchers, as conducted with the 2019 Paleopathology Association workshop on treponemal disease. Paleopathology training in academic environments has existed in some parts of the world for a long time(Buikstra & Roberts, 2012), and the late Don Ortner ran short 2-to 3-week courses intermittently from the 1970s to 2008 in the USA and the UK(Ortner et al., 2012) and general workshops on paleopathology with Bruce Ragsdale at the North American annual meetings of the Paleopathology Association. None of these courses or workshops, however, specifically focused on treponemal disease. ...

Special Courses in Human Skeletal Paleopathology

... It remains uncertain whether bone remodeling serves solely as an endpoint in the progression of a chronic disease or if inflammatory components intrinsic to the bone are causative factors (Leung et al., 2016). Another complicating factor is the limited interpretability of bony changes, as numerous pathologies may present with analogous morphological features in skeletal material (Ortner, 2012;Weston, 2008). It is also crucial to note that benign bone tumors may arise in the paranasal sinuses; these tumors are characterized by a smooth, rounded surface (Tarsitano et al., 2021) (Fig. 3). ...

A Companion to Paleopathology
  • Citing Chapter
  • August 2012

... In order for an individual and the population to be healthy or even just to survive, they must adapt to changing environmental circumstances. Such circumstances include, but are not limited to subsistence mode, socio-political organization, climate, rainfall, temperature, technology, and belief systems (Huss-Ashmore, 2000;Ortner and Schutkowski, 2008). Adaptation can interfere with the normal functioning and homeostasis of an individual and result in systemic stress (Selye, 1984). ...

Ecology, culture and disease in past human populations
  • Citing Chapter
  • January 2008

... Oxenham & Cavill, 2010), possible parasitic infections (e.g. Djuric et al., 2008;Mangas-Carrasco & López-Costas, 2021), and folate deficiency and rickets (Ortner & Mays, 1998). Despite the ongoing discussion about the aetiology of both cribra orbitalia and cribra cranii, these lesions are indicators of nonhealthy conditions (e.g. ...

Dry-Bone Manifestations of Rickets in Infancy and Early Childhood
  • Citing Article
  • January 1998

International Journal of Osteoarchaeology

... The aim of all such practices was to induce a mild case of smallpox to protect a patient from full-blown smallpox later in life. [1][2][3][4] But there were risks: sometimes an individual contracted severe smallpox and could be left blind, scarred, or even dead. Mathematicallyminded doctors calculated the risks of dying from inoculation-roughly 1 in 100 in the 1720sand compared it to the much greater risk of dying from smallpox, about 1 in 7. 5 (Today the case fatality rate for smallpox is estimated to be much higher, roughly 30%). ...

The life and death of smallpox
  • Citing Article
  • May 2005

American Journal of Human Biology