Curious Bone Growth Found on Portuguese Skeleton Buried Centuries Ago

The skeletal remains of a woman who lived in Portugal between the 14th and 19th centuries show that she suffered a physical injury so severe that it caused an extraordinarily large growth to appear on her leg bone, a new study reports. 

While excavating an ancient burial ground at São Julião Church in the tranquil village of Constância, Portugal in 2002, archaeologists dug up the skeleton with this anomalous feature. The large and ugly bone spur had formed on the woman’s femur (upper leg bone), in a location that would have caused her a significant amount of pain.

In a new study just published in the International Journal of Paleopathology, a pair of researchers have revealed the truth about this injury. They claim that it was a consequence of a serious muscle injury, specifically to the pectineus muscle that can be found on the upper and inner part of a person’s thigh.

The lump of excess bone was alarmingly big, having grown to about three inches (8 cm) in size at the time of the woman’s death. The massive growth was on the woman’s right femur (the left femur was actually missing), right at the spot where the pectineus muscle connects the inner thigh bone to the pubic bone. This is an awkward location, and the presence of the injury and associated bone spur would have made it impossible for the unfortunate woman to move around comfortably.

Left; Adult female skeleton (SG.14-SK.7) in situ (Photograph by ©Joana Garcia/Município de Constância). Right; Schematic bone inventory of individual SG.14-SK.7. The visual recording form was adapted from Roksandic (2003). (Assis, Sandra et al./ International Journal of Paleopathology)

The ill-fated woman was approximately five feet (1.54 m) tall, and over the age of 50 when she passed away. For reasons unknown, she was buried on her back with her hands resting on her hips, with a coin placed on her left forearm and her head bent to the right.

The woman’s bones were excavated from what has turned out to be a huge necropolis. So far, the burial sites of 106 adults and 45 children have been discovered at the São Julião Church cemetery, which was used continuously from the 1300s to the 1800s. As of now the researchers involved in this study are uncertain as to when exactly the woman with the bone growth lived and died, although further study of the woman’s skeleton and the site where she was entombed could bring some clarification. 

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A Frightening and Potentially Deadly Injury

It was only after they were cleaning the skeleton back in the laboratory that the archaeologists who found her noticed the shocking lump of bone protruding from her upper right leg. They carefully checked for a fracture, to see if that might have been responsible for triggering the excess bone growth. But no sign of breakage was detected, eliminating that possibility from consideration.

"I have never seen such [a] large bone formation," study lead author Sandra Assis, a biological anthropologist at Portugal’s NOVA University Lisbon, told Live Science. "I was really intrigued by its morphology."

Detail of the curious bone growth found on the femur of an adult female in Constância, Portugal.  (©Sandra Assis/International Journal of Paleopathology)

Based on the location of the growth, Assis believes it would have almost assuredly developed in response to an injury to the pectineus muscle. Such an injury can, in some circumstances, cause a bone growth to form on the femur, and that growth can be surprisingly large if the injury is highly traumatic.

This type of bone abnormality actually has a name: myositis ossificans traumatica (MOT, a benign disorder of bone formation occurring in response to soft tissue trauma. Can be caused by minor or major trauma.) Medical literature confirms that an injury to the pectineus can cause an MOT to form, although this only happens on rare occasions.

"The appearance of the femoral bone suggests a longstanding process," Assis said. "We do not have the medical record of this female, but looking at similar clinical cases we can assume that this femoral lesion was quite debilitating."

Surgery can correct this condition. But when the woman lived such procedures were unavailable, meaning she would have had no choice but to bear her constant discomfort. She would have suffered a lot when trying to walk, and would not have been able to carry any heavy objects without experiencing acute pain.

The injury could have been anywhere from six weeks to one year old when the woman died, Assis concluded. Since the cause of death is unknown at this time, there is no way to tell if her injury was somehow implicated in her demise.

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An Historic First in Medical Archaeology

This is the first time skeletal remains have ever been found that show signs of myositis ossificans traumatica. That in itself makes this a unique discovery.

Soft tissue decays quickly following burial, and is destroyed completely when bodies are cremated. Consequently, archaeologists seldom get a chance to study or learn anything about muscle injuries. This is one exception to that rule.

“This rare case adds an important contribution to understanding the frequency of severe muscle injuries and their impact on past populations' lives,” Assis and her co-author, Portuguese archaeologist Joana Garcia, wrote in their International Journal of Paleopathology article. 

Since this is the first time this particular abnormality has been observed, it seems likely to have been an uncommon medical outcome in the past, just as it is today. But should another example of this type of condition be found elsewhere, on a skeleton unearthed at another archaeological site, that conclusion might have to be altered.

Top image: Curious bone growth on the femur of an adult female in Constância, Portugal. Source: ©Sandra Assis/International Journal of Paleopathology

By Nathan Falde