Matskási István (szerk.): A Magyar Természettudományi Múzeum évkönyve 81. (Budapest 1989)
Ferencz, M. ; Józsa, L.: Fistulography: a new method in palaeopathological examinations
contrast material is injected into the fistular duct opening to the surface before the X-ray examination. Fistulographic techniques applied in living individuals are not suitable for fossil bones. While abnormal ducts and cavities of the living have osseous-interstitial tissue walls, the viscera of bones found in graves perished long ago. The cavity of the previously closed ossifluent abscess has free access to the medullary canal. For this reason the watery and oily contrast materials used for living patients proved to be unsuitable for palaeoradiological purposes because of their low viscosity. As a first step of our examination we had to compound a contrast material that would not „leak out" from the ossifluent abscess cavity. We made up an oily contrast material containing Micropaque R iodine with Suspensio zinci oleosa (Formula Normális. Pharmacopea Hungarica VI. ) preparation. The zinc contents of this suspension improved the radiation absorbability of the contrast material. The contrast material we produced was a white oily mass with the consistency of honey. Microscopic control found the size of particles being under 20 fim. ANALYTICAL TECHNIQUES The surface of the bones to be examined was washed and dried then the remaining sand was removed by air-flow. The still remaining soil particles were washed out by 150 Hgmm pressure water-jet through the foramen nu tritium from the medullary cavity. After this the bones were X-ray illuminated by a Medicor GT-2 type X-ray machine. This way we could separate intraosseal alterations. Then double-direction X-ray pictures were taken of the bones. The fistulae of the bone surfaces were observed with 6-100 x magnification by a Zeiss „Bioplast" stereomicroscope. A thick hypodermic needle was intubated into the fistular duct selected by microscopy - provided it was spacious enough. When a fistular duct proved to be too narrow we drove in a trocar (with 2 mm outside diameter) of the type used in the phlebography of the caput femuri through the fistula. Than we injected contrast material from a plastic syringe under approximately 100 Hgmm pressure until meeting resistance. The X-ray pictures of the bones were taken after removing the syringe but with the needle remaining in place. FISTULOGRAPHY IN PALAEOPATHOLOGY Our material came to light from the excavation of the late medieval (llth-17th c.) cemetery of Szentkirály directed by A PÁLÓCZI HORVÁTH. A stray tibia was found in the back-filled soil when 15th-16th c. graves were excavated. This tibia probably originated from an earlier grave. The adult male (11th-12th c.) had a well-preserved 35.8 cm long tibia. A robust rough ossified callus can be seen on the border of the middle and the lower thirds of this bone. Several minor fistular ducts can be observed on the medial side of the callus and a 2 mm diameter duct's opening can be seen at about 3 cm from the edge of the callus on the rear surface (Plate I:A). The fracture healed with 15' deviation from the longitudinal axis and 8' deviation from the sagittal axis. The X-ray picture showed no sign of the original fracture. The ossal cortex became thick and the medullary canal tapered. An irregularly shaped approximately 1 cm diameter sequester can be suspected within the callus area in the lateral picture. Fistulography was executed with 5 ml of contrast material via the wider fistular hole on the rear surface. The contrast material filled up an irregular abscess system in the medullar cavity of the tibia (Plate I:B). In the area of the callus the thickered cortex tapered down the intraosseal abscess and gave it an hour-glass shape (Plate I:C). A
