Our study provides a critical assessment of osteological and radiological techniques in the analysis of bioarchaeological samples for evidence of pathology. Teams of physicians, anthropologists, historians, and archaeologists have used these methods to provide a clearer picture of health and disease burden in the past. Of relevance for clinicians, these efforts have led to a reconsideration of the physiology and epidemiology of contemporary disease.We examined 213 18th- to 19th-century adult skeletons from the crypt of St. Bride's Church in London using two methods of skeletal analysis (osteological and radiological). All available bones were examined by an osteologist. Radiographs of the crania, humeri, pelvises, femora, and tibiae were examined by a radiologist. Identified lesions were grouped into nine standard categories used in an osteological examination, and statistical analysis was completed.Among lesion categories, and between lesion categories and age, correlations were weaker among the radiologically analyzed data than among data evaluated osteologically. Correlations between age at death and total number of lesions identified were nearly identical, regardless of the method of lesion identification.Although osteological analysis seemed more sensitive in identifying infectious and neoplastic lesions, radiological analysis often provided a clearer illustration of the extent of these conditions, especially when the lesion involved a large area (eg, osteoporosis or Paget disease). Radiological analysis suggested that, as they age, men accumulate skeletal lesions more rapidly than women. Using bioarchaeological data, our study suggests the potential that radiological analysis might have in the establishment of general baseline levels of ill health in both past and present populations.
