Did Ramesses II really have ankylosing spondylitis? A reappraisal.
OBJECTIVE
To challenge the diagnosis of ankylosing spondylitis in the mummy of Ramesses II that was suggested about 30 years ago and to propose a differential diagnosis for the changes that were detected in the mummy's spine and pelvis.


METHODS
We read and interpreted both the published and unpublished radiographs of the mummy.


RESULTS
Changes in the mummy's spine and pelvis included ossification of the anterior longitudinal ligament at the cervical spine level, ossified enthesopathy of both the right and left rectus femoris tendons as well as the right ischial tuberosity, a large osteophyte at both acetabula margins, no ankylosis of the cervical apophyseal joints and no ankylosis of the right sacroiliac joint.


CONCLUSIONS
The radiologic evidence does not support the claim that Ramesses II had ankylosing spondylitis. Our radiologic reappraisal suggests instead the diagnosis of diffuse idiopathic skeletal hyperostosis. This new diagnosis needs to be validated by a computed tomographic scan of the mummy.
Chhem
Rethy K
RK
Paleoradiology Research Unit, Department of Diagnostic Radiology, London Health Sciences Centre, University of Western Ontario, London, Ont. rethy.chhem@lhsc.on.ca
Schmit
Pierre
P
Fauré
Clement
C
D003937:Diagnosis, Differential; D000076144:Egypt, Ancient; D005197:Famous Persons; D049690:History, Ancient; D006801:Humans; D004057:Hyperostosis, Diffuse Idiopathic Skeletal / Q000000981:diagnostic imaging / Q000266:history*; D008297:Male; D009106:Mummies / Q000000981:diagnostic imaging*; D017887:Ossification of Posterior Longitudinal Ligament / Q000000981:diagnostic imaging / Q000266:history*; D010164:Paleopathology / Q000266:history; D011859:Radiography; D013167:Spondylitis, Ankylosing / Q000000981:diagnostic imaging / Q000266:history*