School of History and Philosophy, Program in History of Science and Medicine, University of New South Wales, Sydney, NSW, Australia.
Rheumatol Int. 2011 Dec;31(12):1649-52. doi: 10.1007/s00296-010-1563-6. Epub 2011 Jan 15.
The Medici family ruled Florence for most of the period from the 1430s to the 1730s, with the senior (primogenito) branch predominating until the line ended in the 1530s and the cadet (secondogenito) branch predominating thereafter. Recent studies have identified a familial syndrome consisting of cutaneous symptoms, peripheral arthropathy and spinal ankylosis in the primogenito branch of the family, and the presence of diffuse idiopathic skeletal hyperostosis (DISH) in two members of the secondogenito branch. These findings raise the question of whether DISH was also a component of the primogenito familial syndrome. The present study provides a further specification of the ossification diathesis in the familial syndrome of the primogenito branch of the Medici family. Recently discovered photographs of exhumed Medici skeletons from the primogenito line are examined, with a focus on spinal, sacro-iliac and peripheral ossifications. These observations are supplemented with published reports of radiological, histological and macroscopic studies of the skeletons. Our interpretations of the ossification data relating to the primogenito branch of the Medici family are supportive of a diagnosis of DISH. DISH was one component of the triple pathology identified as a syndrome in the fifteenth century primogenito Medici line. As a diagnosis of DISH has recently been proposed for two sixteenth century members of the secondogenito branch of the family, it appears that the same condition affected both branches of the Medici lineage, without excluding other forms of undifferentiated joint and spondylarthropathies.
美第奇家族在 15 世纪 30 年代至 18 世纪 30 年代期间统治了佛罗伦萨大部分地区，其中高级（primogenito）分支在 16 世纪 30 年代结束前占主导地位，而低级（secondogenito）分支在那之后占主导地位。最近的研究已经确定了一种家族综合征，其特征是皮肤症状、周围关节炎和脊柱强直，存在于家族的 primogenito 分支中，而在 secondogenito 分支的两名成员中存在弥漫性特发性骨肥厚（DISH）。这些发现提出了一个问题，即 DISH 是否也是 primogenito 家族综合征的一个组成部分。本研究进一步明确了美第奇家族 primogenito 分支家族综合征中的骨形成倾向。最近发现的来自 primogenito 线的美第奇骨骼的挖掘照片被检查，重点是脊柱、骶髂和周围骨化。这些观察结果辅以对骨骼的放射学、组织学和宏观研究的已发表报告。我们对与美第奇家族 primogenito 分支相关的骨化数据的解释支持 DISH 的诊断。DISH 是 15 世纪 primogenito 美第奇线确定的三重病理之一。由于最近提出了 DISH 的诊断，适用于家族 secondogenito 分支的两名 16 世纪成员，因此似乎同一种情况影响了美第奇家族的两个分支，而不排除其他未分化的关节和脊柱关节病的形式。
