Porotic hyperostosis

Porotic hyperostosis, is a pathological condition that affects bones of the cranial vault, and is characterized by localized areas of spongy or porous bone tissue.[1] The diploë, or spongy tissue within the bones of the cranium, swells and the tissue of the outer surface becomes thinner and more porous in appearance.[2][3]

Porotic hyperostosis
Other namesOsteoporosis symmetrica, Cribra crani, Hyperostosis spongiosa, and Symmetrical osteoporosis

This condition was widely accepted as a result of anemia, which is typically due to an iron deficient diet,[4] but several lines of evidence suggest that the accelerated loss and compensatory over-production of red blood cells seen in hemolytic and megaloblastic anemia are the most likely proximate causes of porotic hyperostosis.[5]

In anthropology, the presence of the condition has been considered evidence that a past population suffered chronic or episodic malnutrition. Anthropologists examine bones of past populations to learn about their lifestyles. A sub-discipline known as paleonutrition has focused on the presence of porotic hyperostosis, among other nutritional disorders. A high incidence of the disease indicates the population adapted poorly to its environment or was under nutritional stress.[4] A low level of iron in the blood is also a defense against pathogens, so a high incidence of the disease in a population could also indicate an attempt to fight off an infectious disease.[4] From this perspective, porotic hyperostosis could be viewed as a biological attempt to adapt to the environment, rather than an indicator of malnutrition.[citation needed]


  1. ^ El-Najjar M and Robertson Jr AL. 1976. Spongy bones in prehistoric MARICOTAS. Science Volume 193, Issue 4248, Pages 141-143. Retrieved on July 9, 2007.
  2. ^ Angel JL. 1966. Porotic Hyperostosis, Anemias, Malarias, and Marshes in the Prehistoric Eastern Mediterranean. Science Volume 153, Number 3737, Pages 760-763. Retrieved on July 9, 2007.
  3. ^ Cule J and Evans IL. 1968. Porotic hyperostosis and the Gelligaer skull. Journal of Clinical Pathology, Volume 21, Issue 6, Pages 753–758. Retrieved on July 9, 2007.
  4. ^ a b c Stuart-Macadam P. 1992 Porotic hyperostosis: a new perspective. American Journal of Physical Anthropology. Volume 87, Issue 1, Pages 39-47. PMID 1736673. Retrieved on July 9, 2007.
  5. ^ Walker PL et al (2009) The causes of porotic hyperostosis and cribra orbitalia: a reappraisal of the iron-deficiency-anemia hypothesis. Am J Phys Anthropol 139(2):109-125