The Diagnostic Implications of Two Cases of Known Rheumatoid Arthritis from the CAL Milano Cemetery Skeletal Collection

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 v...

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Bibliographic Details
Published inJournal of forensic sciences Vol. 63; no. 6; pp. 1880 - 1887
Main Authors Biehler‐Gomez, Lucie, Cattaneo, Cristina
Format Journal Article
LanguageEnglish
Published United States Wiley Subscription Services, Inc 01.11.2018
Subjects
Aged
Aged, 80 and over
Arthritis
Arthritis, Rheumatoid - pathology
Biocompatibility
Biomedical materials
Bone and Bones - pathology
Bones
Collection
Diagnosis
Diagnosis, Differential
Diagnostic systems
erosive arthropathy
Female
Forensic Anthropology
Forensic science
Hand (anatomy)
Humans
Italy
joint disease
Joints - pathology
Lesions
Osteoarthritis - pathology
Rheumatoid arthritis
forensic science
diagnosis
forensic anthropology
joint disease
rheumatoid arthritis
erosive arthropathy
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Summary: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.
ISSN:0022-1198
1556-4029
DOI:10.1111/1556-4029.13799