BILATERAL FEMORAL AND TIBIAL PERIOSTITIS IN THE LA FERRASSIE-1 NEANDERTHAL

Preserved in the older adult male La Ferrassie 1 skeleton are the skul l, all of the major long-bone diaphyses and most epiphyses, the scapul ae and pelvis, most of the hand and foot remains with minor damage, an d fragmentary elements of the majority of the axial skeleton. In addit ion to periodontal lesions, minor vertebral osteoarthritis, and a frac tured greater trochanter, La Ferrassie 1 exhibits marked bilateral, la rgely symmetrical periostitis of the distal femoral diaphyses and espe cially of the distal tibial diaphyses, with less pronounced involvemen t of the proximal tibial and distal fibular diaphyses. The preserved p eriosteal new bone is not invasive of the underlying cortical bone, no r is it present inside the articular capsule attachment areas or on th e subchondral bone. There is minimal involvement of the upper limb lon g bones, but not of the hand or foot remains. The periostitis therefor e appears as a bilateral, highly active, localized set of lesions at t he time of death. Differential diagnosis suggests that these lesions a re the result of a systemic involvement, most likely hypertrophic pulm onary osteoarthropathy (HPO) (also called secondary hypertrophic osteo arthropathy). The primary cause of HPO is usually thoracic infection a nd/or carcinomas, most often pulmonary. Secondary lesions commonly ass ociated with this, but not present on La Ferrassie 1 to the extent of skeletal involvement, are clubbed fingers and toes with metacarpal, me tatarsal and phalangeal periostitis in advanced cases. Consequently, L a Ferrassie 1 appears to have had a sufficiently acute case of HPO to produce pronounced femoral and tibial periarticular periostitis but no t sufficiently advanced for hand and/or foot involvement. This is the only known case of systemic effects of an infection/carcinoma among th e Neanderthals. (C) 1997 Academic Press Limited.