X-ray reads of long-dead Londoners relevant to healthcare today

Radiology has much to offer in establishing general levels of health or illness in populations of the past, and these insights can meaningfully inform modern-day medicine, according to researchers who examined the skeletons of more than 200 adults laid to rest during the 1700s and 1800s in the crypt of St. Bride’s Church in London.

Their study report is running in the October edition of Academic Radiology.

Lead author Katherine van Schaik, MA, of Harvard, senior author Frank Rühli, MD, PhD, of the University of Zürich, and colleagues had all available bones from sufficiently intact skeletons with historically verifiable age-at-death information examined by a radiologist as well as an osteologist.

The diagnostic duet provided comparative as well as complementary data.

The radiologist worked with x-rays of the crania, humeri, pelvises, femora and tibiae.

The osteologist analyzed all available bones for each adult skeleton, using exam protocols standard to that profession.

All lesions were identified and grouped into nine macro-level pathology codes—congenital, infectious, joints, trauma, metabolic, endocrine, neoplastic, circulatory and miscellaneous.

The team further differentiated these findings into more specific pathologic diagnoses.

Analyzing the differences in findings, the researchers observed the osteological evaluations identified more lesions per skeleton and “seemed more sensitive in identifying infectious and neoplastic lesions.” However, the radiological analysis “often provided a clearer illustration of the extent of these conditions, especially when the lesion involved a large area (e.g., osteoporosis or Paget disease).”

The authors cite bioarchaeological data to point out the potential of radiological analysis to aid in “the establishment of general baseline levels of ill health in both past and present populations.”

“Historians often speak of how we might look to the past to understand our present and our future,” the authors write in their discussion. “Physicians, too, consider the outcomes of past cases to learn how to predict future outcomes. Radiology provides important tools that can help historians and bioarchaeologists better understand the burden of disease in the past, so that we can more completely contextualize our knowledge of human health and disease from an extended, evolutionary perspective.”

They suggest their present study is applicable to future radiology research and practice, as “radiological analysis might identify past variations in disease patterns that could be relevant for populations today.”