Mini journal logo  Home Issue Contents All Issues

Radiographic Technique for Archaeological Human Dry Bones: a scoping review

James Elliott

Cite this as: Elliott, J. 2022 Radiographic Technique for Archaeological Human Dry Bones: a scoping review, Internet Archaeology 59.


Composite images of bone X-rays
Example radiographs (from Elliott in press). Image credit: J. Elliott

Within archaeological research, radiography has been used with human dry bones to diagnose pathologies, demonstrate trauma and assist age estimation through dentition eruption status. This study concerns the acquisition of radiographs, including technical parameters, imaging workflow and associated quantitative analysis of bone. Collectively, these themes can be grouped under the term radiographic technique. Despite its indispensability, the available guidance literature for appropriate radiographic technique in archaeology appears sparse. The aim of this research was to quantify and characterise current knowledge and recommendations related to radiographic technique. A scoping review was conducted, involving a systematic search of academic literature within the last 20 years. Archaeological academic textbooks and journal articles from any geographical location or time period were included but were limited to studies involving human dry bone and written in the English language. Of 244 potential studies, results identified seventeen journal articles and four academic textbooks with direct recommendations or guidance for radiographic technique. The primary reason for exclusion was the omission of methodological detail. The majority of included texts addressed the identification of pathologies, cortical thickness or detection of Harris lines. While recommendations exist, gaps in the knowledge include dedicated guidelines for specific anatomy and the integration of photography during radiographic imaging.

  • Google Scholar
  • Keywords: radiographic technique, workflow, process, osteoarchaeology, paleopathology, protocol, scoping review
  • Accepted: 1 March 2022. Published: 21 March 2022
  • PDF download (main article text only)
  • Funding: This project has been funded by the College of Radiographers Industry Partnership Scheme Research Grant (Grant number 186, 2020).

Corresponding author: James ElliottORCID logo
Canterbury Christ Church University

Full text

Figure 1: PRISMA 2020 flowchart of study selection and inclusion process

Figure 2: Literature map for radiography of human dry bones across 21 publications

Table 1: Inclusion and exclusion eligibility criteria

Table 2: Scoring system for inclusion during full reading of literature

Table 3: Recommendations for dry human bone radiography per publication

Agarwal, S.C. 2018 'Understanding bone aging, loss, and osteoporosis in the past' in M.A. Katzenberg and A.L. Grauer (eds) Biological Anthropology of the Human Skeleton, 3rd edition, Hoboken: John Wiley & Sons. 385-414.

Ameen, S., Staub, L., Ulrich, S., Vock, P., Ballmer, F. and Anderson, S.E. 2005 'Harris lines of the tibia across centuries: a comparison of two populations, medieval and contemporary in Central Europe', Skeletal Radiology 34(5) 279-84.

Arksey, H. and O'Malley, L. 2005 'Scoping studies: towards a methodological framework', International Journal of Social Research Methodology: Theory and Practice 8(1), 19-32.

Ashifa, N., Parakh, M.K. and Ulaganambi, S. 2020 'Estimation of age using third molar development', American Journal of Forensic Medicine and Pathology 41(2), 115-18.

Beauchesne, P. and Agarwal, S.C. 2017 'A multi-method assessment of bone maintenance and loss in an Imperial Roman population: implications for future studies of age-related bone loss in the past', American Journal of Physical Anthropology 164(1), 41-61.

Beckett, R.G. 2014 'Paleoimaging: a review of applications and challenges', Forensic Science, Medicine and Pathology 10, 423-36.

Beckett, R.G. and Conlogue, G.J. 2010 Paleoimaging: Field applications for cultural remains and artifacts, London: CRC Press.

Beckett, R.G., Conlogue, G.J. and Nelson A. 2020a Case Studies for Advances in Paleoimaging and Other Non-clinical Application, Boca Raton: CRC Press.

Beckett, R.G., Conlogue, G.J., Viner, M.D., Saleemd, S.N., Said, A.H. and Piombino-Mascali, D. 2020b 'A paleoimaging study of human mummies held in the mother church of Gangi, Sicily: implications for mass casualty methodology', Forensic Imaging 23, 200416.

Bethard, J.D., Ainger, T.J., Gonciar, A. and Nyárádi, Z. 2021 'Surviving (but not thriving) after cranial vault trauma: a case study from Transylvania', International Journal of Paleopathology 34, 122-129.

Biehler-Gomez, L., Tritella, S., Martino, F., Campobasso, C.P., Franchi, A., Spairani, R., Sardanelli, F. and Cattaneo, C. 2019 'The synergy between radiographic and macroscopic observation of skeletal lesions on dry bone', International Journal of Legal Medicine 133(5), 1611-28.

Bruwelheide, K.S., Beck, J. and Pelot, S. 2001 'Standardized protocol for radiographic and photographic documentation of human skeletons' in E. Williams (ed) Human Remains: Conservation, Retrieval and Analysis. British Archaeological Reports (Int. Ser.) 934, Oxford: Archaeopress. 153–65.

Chhem, R.K. 2006 'Paleoradiology: imaging disease in mummies and ancient skeletons', Skeletal Radiology 35(11), 803-4.

Chhem, R.K. and Brothwell, D.R. 2008 Paleoradiology: Imaging mummies and fossils, New York: Springer.

Cieślik, A.I., Dąbrowski, P. and Przysiężna-Pizarska, M.A. 2017 'The face of conflict: significant sharp force trauma to the mid-facial skeleton in an individual of probable 16th–17th century date excavated from Byczyna, Poland', International Journal of Paleopathology 17, 75-78.

Conlogue, G.J. and Beckett, R.G. 2020 Advances in Paleoimaging: Applications for paleoanthropology, bioarchaeology, forensics, and cultural artifacts, Boca Raton: CRC Press.

Conlogue, G., Beckett, R., Bailey, Y., Posh, J., Henderson, D., Double, G. and King, T. 2008 'Paleoimaging: The use of radiography, magnetic resonance, and endoscopy to examine mummified remains', Journal of Radiology Nursing 27(1), 5-13.

Conlogue, G., Nelson, A.J. and Guillén, S. 2004 'The application of radiography to field studies in physical anthropology', Canadian Association of Radiologists Journal 55(4), 254-57.

Cope, D.J. and Dupras, T.L. 2011 'Osteogenesis imperfecta in the archeological record: an example from the Dakhleh Oasis, Egypt', International Journal of Paleopathology 1(3-4), 188-99.

Dabernat, H. and Crubézy, É. 2009 'Multiple bone tuberculosis in a child from Predynastic Upper Egypt (3200 BC)', International Journal of Osteoarcheology 20, 719–30.

Elliott, J. in press 'Radiography of human dry bones: a reflective account with recommendations for practice', Radiography.

Évingera, S., Bernert, Z., Fóthi, E., Wolff, K., Kővári, I., Marcsikd, A., Donoghue, H.D., O'Grady, J., Kiss, K.K. and Hajdu, T. 2011 'New skeletal tuberculosis cases in past populations from Western Hungary (Transdanubia)', HOMO: Journal of Comparative Human Biology 62, 165-83.

Fatula, S. 2021 'Detection of cancerous lesions in skeletal remains using visual methods and radiographs', International Journal of Osteoarchaeology 31, 916-25.

Flensborg, G. and Martínez, G. 2021 'Calcaneus fracture in a Middle Holocene individual from the eastern Pampa-Patagonian transition (Argentina)', Journal of the Mechanical Behavior of Biomedical Materials 120, 104568.

Garvin, H.M. and Stock, M.K. 2016 'The utility of advanced imaging in forensic anthropology', Academic Forensic Pathology 6(3), 499-516.

Gilmour, R., Brickley, M.B., Hoogland, M., Jurriaans, E., Mays, S. and Prowse, T.L. 2021 'Quantifying cortical bone in fragmentary archeological second metacarpals', American Journal of Physical Anthropology 174, 812-21.

Gooderham, E., Marinho, L., Spake, L., Fisk, S., Prates, C., Sousa, S., Oliveira, C., Santos, A.L. and Cardoso, H.F.V. 2020 'Severe skeletal lesions, osteopenia and growth deficit in a child with pulmonary tuberculosis (mid-20th century, Portugal)', International Journal of Paleopathology 30, 47-56.

Ives, R. and Brickley, M.B. 2004 'A procedural guide to metacarpal radiogrammetry in archaeology', International Journal of Osteoarchaeology 14, 7-17.

Kristóf, L.A., Kovács, M., Baksa, G., Bereczki, Z., Szatmári, F., Patonay, L., Pálfi, G. and Pohárnok L. 2015 'Condition assessment of two early Christian martyrs, St Christine's and St Augustine's relics with paleoradiological methods in Hungary', Journal of Cultural Heritage 16(2), 249-53.

Leo, C., O'Connor, J.E. and McNulty, J.P. 2013 'Combined radiographic and anthropological approaches to victim identification of partially decomposed or skeletal remains', Radiography 19, 353-62.

Licata, M., Tosi, A., Ciliberti, R., Badino, P. and Pinto, A. 2019 'Role of radiology in the assessment of skeletons from archeological sites', Seminars in Ultrasound, CT and MRI 40(1), 12-17.

Long, B.W., Hall Rollins, J. and Smith, B.J. 2020 Merrill's Atlas of Radiographic Positioning and Procedures, 14th edition. St Louis: Mosby.

Manifold, B.M. 2014 'Photodensitometry: a useful method for studying bone mineral density in the skeletal remains of children', Bulletin of the International Association for Paleodontology 8(1), 187-94.

Mays, S. 2007 'Radiography and allied techniques in the palaeopathology of skeletal remains' in R. Pinhasi and S. Mays (eds) Advances in Human Palaeopathology, Chichester: Wiley. 77–100.

Mays, S. 2016 'Bone-formers and bone-losers in an archaeological population', American Journal of Physical Anthropology 159(4), 577-84.

Meyer, S., Frater, N., Seiler, R., Bickel, S., Bönia, T., Eppenberger, P. and Rühli, F. 2020 'Multidisciplinary studies of heavily fragmented and commingled ancient Egyptian human remains found in KV 40 (Valley of the Kings, Luxor, Egypt): a pragmatic workflow and first results', Journal of Archaeological Science: Reports 29, 102069.

Mitchell, P.D. and Brickley, M. 2017 Updated Guidelines to the Standards for Recording Human Remains (Chartered Institute for Archaeologists). [Last accessed: 14 February 2021]

Nystrom, K.C., Braunstein, E.M. and Buikstra, J.E. 2004 'Field paleoradiography of skeletal material from the Early Classic Period of Copan, Honduras', Canadian Association of Radiologists Journal 55(4), 246-53.

Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D., Shamseer, L., Tetzlaff, J.M., Akl, E.A., Brennan, S.E., Chou, R., Glanville, J., Grimshaw, J.M., Hróbjartsson, A., Lalu, M.M., Li, T., Loder, E.W., Mayo-Wilson, E., McDonald, S., McGuinness, L.A., Stewart, S., Thomas, J., Tricco, A.C., Welch, V.A., Whiting, P. and Moher, D. 2021 'The PRISMA 2020 statement: an updated guideline for reporting systematic reviews', BMJ 372, n71.

Papagrigorakis, M.J., Karamesinis, K.G., Daliouris, K.P., Kousoulis, A.A., Synodinos, P.N. and Hatziantoniou, M.D. 2012 'Paleopathological findings in radiographs of ancient and modern Greek skulls', Skeletal Radiology 41, 1605-11.

Peters, M.D., Godfrey, C.M., Khalil, H., McInerney, P., Parker, D. and Soares, C.B. 2015 'Guidance for conducting systematic scoping reviews', International Journal of Evidence-Based Healthcare 13(3), 141–46.

Purchase, S.L., Bazaliiskii, V.I. and Lieverse, A.R. 2019 'An innovative method to visualise mastoiditis using a hand-held X-ray system', International Journal of Paleopathology 26, 22-26.

Primeau, C., Jakobsen, L.S. and Lynnerup, N. 2016 'CT imaging vs. traditional radiographic imaging for evaluating Harris Lines in tibiae', Anthropologischer Anzeiger: Journal of Biological and Clinical Anthropology 73(2), 99-108.

Ramírez-Salomón, M., Vega-Lizama, E., Quintana-Owen, P., Cucina, A. and Tiesler, V. 2018 'Pulp pathosis associated with ancient Maya dental inlays', Archives of Oral Biology 95, 202-8.

Scott, A.B. and Hoppa, R.D. 2015 'A re-evaluation of the impact of radiographic orientation on the identification and interpretation of Harris Lines', American Journal of Physical Anthropology 156, 141-47.

Seiler, R., Eppenberger, P. and Rühli, F. 2018 'Application of portable digital radiography for dental investigations of ancient Egyptian mummies during archaeological excavations: evaluation and discussion of the advantages and limitations of different approaches and projections', Imaging Science in Dentistry 48(3), 167-76.

Silva, R.F., Franco, A., Dias, P.E.M., Gonçalves, A.S. and Paranhos, L.R. 2013 'Interrelationship between forensic radiology and forensic odontology — A case report of identified skeletal remains', Journal of Forensic Radiology and Imaging 1, 201-206.

Symmons, R. 2004 'Digital photodensitometry: a reliable and accessible method for measuring bone density', Journal of Archaeological Science 31(6), 711-19.

Vallis, J. 2017 'The role of radiography in disaster victim identification' in T. Thompson and D. Errickson (eds) Human Remains: Another dimension: The application of imaging to the study of human remains, London: Academic Press. 57-69.

van der Merwe, A.E., Veselka, B., van Veen, H.A., van Rijn, R.R., Colman, K.L. and de Boe, H.H. 2018 'Four possible cases of osteomalacia: the value of a multidisciplinary diagnostic approach', International Journal of Paleopathology 23, 15-25.

van Schaik, K., Eisenberg, R., Bekvalac, J. and Rühli, F. 2017 'The radiologist in the crypt: burden of disease in the past and its modern relevance', Academic Radiology 24(10), 1305-11.

van Schaik, K., Eisenberg, R., Bekvalac, J., Glazer, A. and Rühli, F. 2019 'Evaluation of lesion burden in a bone-by-bone comparison of osteological and radiological methods of analysis', International Journal of Paleopathology 24, 171-74.

Wanek, J., Papageorgopoulou, C. and Rühli, F. 2021 'Fundamentals of paleoimaging techniques: bridging the gap between physicists and paleopathologists' in A.L. Grauer (ed) A Companion to Paleopathology. Chichester: Blackwell Publishing Ltd. 324-38.

Whitley, A.S., Jefferson, G., Holmes, K., Sloane, C., Anderson, C. and Hoadley, G. 2015 Clark's Positioning in Radiography, 13th edition. London: CRC Press.

Internet Archaeology is an open access journal based in the Department of Archaeology, University of York. Except where otherwise noted, content from this work may be used under the terms of the Creative Commons Attribution 3.0 (CC BY) Unported licence, which permits unrestricted use, distribution, and reproduction in any medium, provided that attribution to the author(s), the title of the work, the Internet Archaeology journal and the relevant URL/DOI are given.

Terms and Conditions | Legal Statements | Privacy Policy | Cookies Policy | Citing Internet Archaeology

Internet Archaeology content is preserved for the long term with the Archaeology Data Service. Help sustain and support open access publication by donating to our Open Access Archaeology Fund.