Cribra orbitalia and porotic hyperostosis: A biological approach to diagnosis
Cribra orbitalia and porotic hyperostosis: A biological approach to diagnosis
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DOI：
10.1002/ajpa.23701
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发表时间：
2018-12-01
影响因子：
2.8
通讯作者：
Brickley, Megan B.
中科院分区：
文献类型：
--
作者：
Brickley, Megan B.
目的颅骨的多孔性病变（眶嵴和多孔性骨质增生）是在考古人骨中发现的最常见的病变类型之一，在古人类和非人灵长类动物中也有发现。由于这种病变经常被发现，关于可能的原因以及它们是否有联系一直存在广泛的争论，其中大部分争论都集中在贫血上。唐·奥特纳（Don Ortner）使用的古病理学诊断的生物学方法，以及西蒙·梅斯（Simon Mays）最近更正式地提出的古病理学诊断技术，可能提供了一种回答围绕这些病变的一些问题的方法。材料与方法结果回顾了红骨髓与混合骨髓的类型分布和转化模式的变化，以及黄骨髓再转化的潜力随年龄的增长。还考虑了可能导致多孔病变发展的其他条件的范围和类型。结合生物医学文献中关于骨髓类型和年龄转换模式的信息，仔细评估颅骨和骨骼其余部分多孔病变的类型和位置，将有助于建议诊断。多种情况下可在颅穹窿和眶顶产生多孔性病变，但由于解剖结构和生理因素，这种病变更容易发生在眶顶。贫血可以在这两个部位产生病变，但需要骨髓扩张的证据来证实它是病因。
Objectives Porotic lesions of the skull (cribra orbitalia and porotic hyperostosis) are one of the most common types of lesion identified in archaeological human bone and have also been found in hominins and non-human primates. Because of the frequency with which such lesions are found there has been extensive debate on the possible causes and whether they are linked, with much of the debate centering on anemia. The biological approach to diagnosis in paleopathology used by Don Ortner and recently proposed more formally as a technique to facilitate diagnosis in paleopathology by Simon Mays may offer a means of answering some of the questions surrounding these lesions. Materials and Methods Results A review was undertaken of biomedical information on changes in the distribution of marrow type and pattern of conversion of red and mixed marrow, and the potential for re-conversion of yellow marrow with age. The range and type of other conditions that might result in the development of porous lesions were also considered. Combining information from the biomedical literature on marrow type and patterns of conversion with age, with careful evaluation of the type and location of porous lesions in the skull and across the rest of the skeleton will assist in suggesting a diagnosis. Discussion A wide range of conditions can produce porous lesions in the cranial vault and the orbital roof, but due to anatomical structures and physiological factors such lesions are more likely to occur in the orbital roof. Anemia can produce lesions in both locations, but evidence of marrow expansion is required to confirm it as a cause.