A Neolithic case of fibrous dysplasia from Çatalhöyük (Turkey)

The vast majority of primary burials at Neolithic Çatalhöyük (Central Anatolia, Turkey, 7100-6000cal BC) are recovered from beneath house floors, with burials in external spaces extremely rare. Excavations at Çatalhöyük in 1998 brought to light a young adult male buried in a midden (a burial location observed so far for only 4 out of 440 individuals), showing a suite of pathological features affecting the entire skeleton. The observed pathological changes include perimortem and antemortem fractures, proliferative and resorptive areas, thinning of the bone cortex, and localized areas of disorganized spongy bone invaded by fibrous tissue. We propose a differential diagnosis by considering a set of conditions: Paget's disease, osteomyelitis, hyperparathyrhoidism, Ollier's disease, fibrosarcoma, and fibrous dysplasia. The severity and distribution of the observed skeletal changes are consistent with a diagnosis of polyostotic fibrous dysplasia, a possibly debilitating and disfiguring condition. This, together with an unusual depositional context, may suggest a socially-mediated reaction to this individual's infirmity.