Erosive polyarthropathy in a Late Roman skeleton from northern France: A new case of rheumatoid arthritis from the pre-Columbian Old Word?

A skeleton from the Late Roman period, recovered in Amiens, northern France, exhibits multiple symmetrical marginal erosions, primarily involving the metacarpophalangeal and metatarsophalangeal joints. Other skeletal changes include erosions of several peripheral joints and some entheses, and severe osteoporosis. Macroscopic and radiological aspects of the lesions, as well as the absence of spinal and sacroiliac joints involvement, are consistent with a diagnosis of rheumatoid arthritis. Differential diagnosis includes other erosive arthropathies, in particular the diseases belonging to the spondyloarthropathy group. This case provides a new evidence of the presence of rheumatoid arthritis in Western Europe long before the colonisation of the Americas by Europeans.