Bilateral hip dysplasia in a South African male: A case study from the 17-18th century

To identify, critically analyse and describe severe bilateral skeletal pathology involving the ossa coxae of an individual from historic era Cape Town.

A single individual from the University of Cape Town's Human Skeletal Repository was analysed under research approval (HREC# 035/2021).

An osteobiography was constructed, radiocarbon dating and isotopic analyses were conducted. Pathological description and contextualised disability analyses followed, along with differential diagnosis. The pelvis and femora were visualised macroscopically and radiographically.

This individual was a non-European middle-aged adult male who lived in the 17-18th centuries CE. Morphological changes showed hypoplastic hips with collapsed femoral heads and neoacetabulae. A diagnosis of developmental dysplasia of the hips (DDH) was made. Then a contextualised disability analysis including consideration of the clinical and functional impacts of the condition were applied. No signs of maltreatment, physiological stress or persistent infections were present. His bones were well developed, illustrating mobility and use.

He developed DDH early in life and lived through adulthood, and his strong, healthy bones suggest resilience, some mobility and contribution to society through less physically demanding tasks.

Value for palaepathological analyses to inform and understand disability and culturally significant health mediation to offer a more objective interpretation and improve understanding of past people. It expands our understanding of the presence of DDH globally and in Africa and provides insight into disease impact for individuals with bilateral expression.

Further contextual research is required.

Poor scene recovery hindered in-depth care analysis and interpretation of the condition.