An identified case of poliomyelitis: contribution to diagnosis in ancient human remains

This article describes the skeletal remains of a 20th-century individual diagnosed with poliomyelitis in childhood who suffered from atrophy and muscle weakness as an adult. The study provides a detailed analysis of both the primary effects of polio in the skeleton and the secondary effects across a lifetime, and contributes to the future identification of this pathology in osteoarchaeological assemblages. A skeleton of an 82-year-old male with poliomyelitis, from Tierra de la Reina, León (Spain) was submitted to bone densitometry, morphological, metric, cross-sectional, and palaeopathological analyses. Conventional X-rays and computed tomography scans were also performed. Skeletal alterations were categorized as directly and indirectly related to polio. The latter were probably acquired during life, resulting from mobility problems, malposition, and/or advanced age. Discrepancies in size, primarily related to polio, were observed between the right and left sides of the skeleton, with the left side being smaller and more gracile. However, while the asymmetry of the upper limbs is mainly in robustness, in the lower limbs the differences are in both robustness and length. This paper illustrates the skeletal alterations that may be present with poliomyelitis, demonstrating the complexity of diagnosing this pathology in an individual who lived a long life. In fact, many of the observed alterations can be found in other pathological conditions. Therefore, it is concluded that extreme caution be taken when analysing archaeological skeletal remains that are not as complete and well-preserved as this individual. The present work contributes to the diagnosis of poliomyelitis in human remains and underscores its impact in human history. Destructive methods were not authorized; medical records were no longer available. In the future, 3D reconstruction analysis/micro-computed tomography may add new and valuable information.