Objective

To explore the differential diagnoses of a fused left knee joint and the subsequent impairment.

Materials

An adult female skeleton from the Medieval cemetery of St Mary Spital (London, England).

Methods

We employed digital radiography and macroscopic observation to record the changes observed throughout the skeleton. We also used the Index of Care to explore the subsequent impairment.

Results

A range of congenital and developmental conditions were identified throughout the axial skeleton, with changes to the spine, pelvis, arms and leg bones reflecting adaptation to the mobility impairment.

Conclusions

In all probability, the left knee reflects a case of congenital ankylosis with a differential diagnosis of subadult trauma. The female’s skeleton had adapted to the impairment. Their risk is likely to have been elevated because of climatic and pandemic events during this period.

Significance

First reported case of congenital knee ankylosis.

Limitations

The left knee joint was damaged during excavation.

Suggestions for further research

Additional imaging is advised.

中文翻译：

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来自中世纪伦敦的膝关节强直：创伤，先天性异常还是骨关节炎？

目的

探索融合的左膝关节和随后的损伤的鉴别诊断。

用料

来自圣玛丽·斯皮塔尔（英国伦敦）的中世纪公墓的成年女性骨骼。

方法

我们采用数字射线照相术和宏观观察来记录整个骨骼观察到的变化。我们还使用了护理指数来探索随后的损伤。

结果

在整个轴向骨骼中发现了一系列先天和发育状况，脊柱，骨盆，手臂和腿骨的变化反映了对运动障碍的适应。

结论

左膝极有可能反映出先天性强直病，并有亚成人创伤的鉴别诊断。女性的骨骼适应了这种损伤。在此期间，由于气候和大流行事件，他们的风险可能有所增加。

意义

先报道先天性膝关节强直的病例。

局限性

挖掘过程中左膝关节受损。

进一步研究的建议

建议进行额外的成像。