Clues to recognition of kidney disease in archaeologic record: characteristics and occurrence of leontiasis ossium

The possible osseous effect of kidney dysfunction was evaluated in a modern skeletal population for future use in assessment of archaeologic samples. Frequency and distribution on the bones of cysts, articular surface alterations, subperiosteal resorption, porosity, osteochondritis, digital tuft alteration and periosteal reaction were recorded in 94 individuals with known kidney failure in the Hamann-Todd collection. Independent radiologic analysis was also pursued. The results were compared with a control sample. The pattern of joint surface alteration and periosteal reaction may facilitate recognition of chronic renal disease in the osseous record. Subtle manifestations of leontiasis ossium are present in the form of cranial thickening and increased cranial size and weight, but teeth spacing are rare. Pseudo osteomatous lesions are common. This study perhaps explains the apparent rarity of actual leontiasis ossium.