Ragsdale Bruce D, Campbell Roselyn A, Kirkpatrick Casey L
Western Diagnostic Services Laboratory, San Luis Obispo, CA, USA; School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.
Cotsen Institute of Archaeology, University of California, Los Angeles, 308 Charles E. Young Drive North, A210 Fowler Building/Box 951510, Los Angeles, CA, 90095-1510, USA; Paleo-oncology Research Organization, Minneapolis, MN, USA.
Int J Paleopathol. 2018 Jun;21:27-40. doi: 10.1016/j.ijpp.2017.02.002. Epub 2017 Mar 6.
Unlike modern diagnosticians, a paleopathologist will likely have only skeletonized human remains without medical records, radiologic studies over time, microbiologic culture results, etc. Macroscopic and radiologic analyses are usually the most accessible diagnostic methods for the study of ancient skeletal remains. This paper recommends an organized approach to the study of dry bone specimens with reference to specimen radiographs. For circumscribed lesions, the distribution (solitary vs. multifocal), character of margins, details of periosteal reactions, and remnants of mineralized matrix should point to the mechanism(s) producing the bony changes. In turn, this allows selecting a likely category of disease (e.g. neoplastic) within which a differential diagnosis can be elaborated and from which a favored specific diagnosis can be chosen.
与现代诊断医生不同，古病理学家可能仅有骨骼化的人类遗骸，而没有病历、长期的放射学研究、微生物培养结果等。宏观和放射学分析通常是研究古代骨骼遗骸最容易采用的诊断方法。本文推荐一种参考标本X光片对干燥骨标本进行研究的有条理的方法。对于局限性病变，其分布（单发与多发）、边缘特征、骨膜反应细节以及矿化基质残余物应能指向产生骨质改变的机制。相应地，这有助于选定一个可能的疾病类别（如肿瘤性疾病），在该类别内可以展开鉴别诊断，并从中选择一个最有可能的具体诊断。
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