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whole skeleton.JPG

the use of
PAget's disease in forensic science

Late Medieval (14th – 15th century AD) skeleton from St Albans Monks’Graveyard, Hertfordshire (United Kingdom)

Imaging medieval remains for Paget's Disease.

James Elliott - February 2023

About the project

In 2017 the remains of 25 skeletons were excavated from Monks' Graveyard in St Albans as part of a routine archaeological service. They dated from the late medieval period, ranging from the 14th-15th century AD. One of which showed considerable changes to the skeleton, with areas of expansion and distortion which suggested Paget's Disease. The pathology is described as disorganised bone remodelling with chaotic bone formation. This in turn creates a distinctive appearance on radiographs (x-rays). 

The suspicion of Paget's Disease led to a radiographic survey of the left tibia, right femur and pelvis fragments. The team included James Elliott, Dr Sarah Stark (originally Southampton University, now Historic England), Adelina Teoaca (Canterbury Archaeological Trust), Dr Lisa Duffy and Dr Ellie Williams (both archaeology staff at Canterbury Christ Church University). Images were reviewed by consultant radiologist Dr Alexis Corrigan of Maidstone and Tunbridge Wells NHS Trust.  

The radiographic images confirmed the diagnosis with thickening of the cortex (outer bone) and haphazard formation of bone within the affected portions. Anthropological assessment of the skeleton were strongly suggestive of an adult male of advanced age. This is in keeping with previous research and a correlation can be found between diagnosis of this pathology and the likehood of the individual being an adult male of advanced age. Furthermore, the pathology appears to be more common with those of British (white) descent according to the currently available research. 

Linking these concepts together, the finding of Paget's Disease may aid biological profiling for the deceased in forensic contexts where fragmented skeletal material is found. Radiography may afford a practical and financially viable method of acquiring evidence for forensic purposes. 


Findings of the study have been published within Forensic Imaging

affected skeleton.JPG

Skeletal elements with areas of significant bony change highlighted in red. Black represents absent anatomy.


Supplementary file: Extra photos of the remains

Additional photographs of the remains are available from the Forensic Imaging website and below. All photos were taken by Adelina Teoaca, Canterbury Archaeologyical Trust.

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