01323nas a2200145   4500000000100000008004100001100001500042700001100057700001300068245009600081300001000177490000600187520097000193022001401163       2015                            d1 aHagihara Y1 aNara T1 aSuzuki T00aSevere erosive polyarthritis in a human skeleton dated to the early modern period of Japan.  a10-180 v83 a<p>A human skeleton apparently afflicted with severe polyarthritis was unearthed from an early modern grave at the Tamukai site in the northernmost part of Honshu in Japan. The bones, likely from a late middle-aged male, showed severe resorptive lesions and ankylosis in many of the peripheral joints. Lesions were found in both bilateral and symmetrical distributions, sometimes accompanied by juxta-articular osteoporosis. Differential diagnoses included either rheumatoid arthritis, psoriatic arthritis, or leprosy, with psoriatic arthritis being the most likely. Whatever the final diagnosis, the identification of arthritis mutilans is clear. Because some bones were missing and a mixture of characteristics of both types of arthritis was evident, it was impossible to make a definitive diagnosis. However, this case is valuable for the severity of the lesions and the rarity of erosive polyarthritis found in archaeological skeletons from an Asian site.</p>
  a1879-9825