Julia Gąsiorowska, Maciej Mateusz Hanypsiak, Natalia Jendrzejaczyk, Artur Ams, Jan Rafał Falana, Karol Zagórski, Katarzyna Rekiel, Kinga Brawańska-Maśluch, Pola Nowacka, Wiktoria Żabińska, Grzegorz Mikita, Piotr Paweł Chmielewski, Krzysztof Data, Paul Mozdziak, Bartosz Kempisty, Paweł Dąbrowski
The paleopathological diagnosis of poliomyelitis currently suffers from a substantial methodological gap due to an overreliance on morphological assessments. Transcending these traditional techniques is essential to definitively confirm ancient cases.
OBJECTIVE: This review aims to describe the macroscopic methods used to detect poliomyelitis in human skeletal remains and to highlight the limitations of current diagnostic frameworks.
MATERIALS: The reviewed materials consist of published paleopathological literature and case studies analyzing human skeletal remains for evidence of the disease.
METHODS: We evaluated existing studies that focus on the macroscopic analysis of secondary skeletal alterations caused by paralysis, such as unilateral limb atrophy, bone shortening, pronounced asymmetry, and compensatory hypertrophy.
RESULTS: Current diagnostic frameworks rely almost exclusively on macroscopic markers; notably, none of the reviewed studies utilized molecular or genetic techniques. Consequently, definitively confirmed cases of ancient poliomyelitis remain exceptionally rare.
CONCLUSIONS: The paleopathological diagnosis of poliomyelitis currently suffers from a substantial methodological gap due to an overreliance on morphological assessments. Transcending these traditional techniques is essential to definitively confirm ancient cases.
SIGNIFICANCE: Analyzing skeletal evidence provides crucial insights into how this debilitating viral infection afflicted human populations in antiquity. It also underscores the importance of rigorous differential diagnosis to distinguish poliomyelitis from other paralytic etiologies, such as cerebral palsy.