Comparison of gross assessment with radiographic, microtomodensitometric and histological analysis of bone and implications for the paleopathology of immatures

The paleopathology of children faces difficulties in establishing reliable and precise diagnoses. Changes in the superficial layer of a bone, the first sign that the paleopathologist can observe, may be due to inflammatory, infectious, deficiency, traumatic or physiological changes. The characterization of the underlying bone is therefore often essential to narrow down the diagnosis. Using a standardized descriptive protocol, we sought to identify the predictive power of the surface aspect of the periosteum relative to the osseous aspects visible by radiography, microtomodensitometry and histology. For this purpose, we used a corpus of 39 individuals who died before the age of 3 years and who were buried in medieval and modern Norman cemeteries. The results show that macroscopic descriptions are poorly associated with other descriptions and that the combination of several analytical methods is essential to establish a link between surface appearance and tissue changes.