Decoding Ancient Ailments: In a tomb on the western bank of the Nile, Dr Maria Carmela Gatto (Polish Academy of Sciences) discovered the remains of a woman in her late twenties. When examining the bones, the archaeologist and her team found that the Nubian woman, who lived in the 18th century BC in the so-called Pan-Grave culture, suffered from rheumatoid arthritis – one of the oldest known cases of arthritis in the world. Although rheumatoid arthritis was only clinically defined in the 17th century, it therefore already existed in Ancient Egypt. We asked Dr Maria Gatto, Dr Madeleine Mant and Dr Mindy Pitre how such a disease can be diagnosed almost 4000 years later and what the find tells us about health and disease in ancient Egypt.
"Paleopathologists use clinical and archaeological evidence to work out their differential diagnoses"
L.I.S.A.: How can arthritis be diagnosed after so many years? What distinguishes rheumatoid arthritis from other diseases?
Dr. Gatto: Paleopathology is the study of disease in human remains from archaeological sites. Joint disease is a commonly recorded form of pathology; it is possible to identify conditions such as osteoarthritis, rheumatoid arthritis, and gout from studying the patterning and type of lesions found in skeletons. Rheumatoid arthritis is an erosive arthritis, meaning that bone is destroyed by the disease process, leaving smooth, carved out lesions at the margins of the joints. This condition primarily affects the small bones of the hands and feet and is symmetrical, meaning it affects both the right and left sides. By conducting a differential diagnosis – listing all possible conditions that might be represented by a set of lesions and working out through process of elimination which is the best fit – it was possible to narrow down the assessment to indicate that this individual likely had a case of rheumatoid arthritis. Paleopathologists use clinical and archaeological evidence to work out their differential diagnoses.