Diffuse idiopathic skeletal hyperostosis in the Medici, Grand Dukes of Florence (XVI century).
Diffuse idiopathic skeletal hyperostosis (DISH) is a common systemic disorder characterised by the ossification of the anterior longitudinal spinal ligament involving at least three contiguous vertebrae and by diffuse extraspinal enthesopathies. The condition is associated with the male sex and with advanced age; its aetiology is uncertain, but seems to be related to obesity and diabetes. The most recent studies in archaeological series demonstrated a relation between high social status and the incidence of DISH. The present study examines two cases of DISH found amongst the members of the Medici family buried in the Basilica of San Lorenzo in Florence. The skeletons of the Grand Dukes Cosimo I (1519-1574) and his son Ferdinand I (1549-1609) showed the typical features of the condition. This result is related to the obesity of the Grand Dukes, attested by the written and artistic sources, and to the protein-based alimentation demonstrated by a paleonutritional study, thus furnishing further evidence to the significance of DISH as a life style.
Giuffra
Valentina
V
Division of Palaeopathology, History of Medicine and Bioethics, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Via Roma 57, 56126 Pisa, Italy. v.giuffra@med.unipi.it
Giusiani
Sara
S
Fornaciari
Antonio
A
Villari
Natale
N
Vitiello
Angelica
A
Fornaciari
Gino
G
D020083:Acquired Hyperostosis Syndrome / Q000000981:diagnostic imaging / Q000266:history*; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000266:history*; D049669:History, 16th Century; D049670:History, 17th Century; D006801:Humans; D007558:Italy; D017846:Longitudinal Ligaments; D008297:Male; D009765:Obesity / Q000000981:diagnostic imaging / Q000266:history*; D011859:Radiography; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000266:history*