A case of septic arthritis of the hip in Central Plains, China, during the Western Han Dynasty (3rd century BCE–1st century CE)

Septic arthritis is not commonly reported in paleopathology. This study aims to provide a differential diagnosis of septic arthritis by looking at a case from ancient China. We also aim to add to the current literature on septic arthritis in paleopathology. One adult male skeleton recovered from the Dapuzi Cemetery, Shaanxi, dating to the Western Han Dynasty (3rd century BCE–1st century CE). Macroscopic observations were conducted. The lytic appearance and massive new bone formation on the left acetabulum of M142 are compatible with septic arthritis. The hip pathology greatly influenced his stature. The two femur shafts present different degrees of robusticity. He also showed severe osteoarthritis. The individual suffered from septic arthritis of the hip, of unknown cause, for a long period, which greatly influenced his daily life. Complications included osteoarthritis, shortened stature, and difficulties in walking. This study offers a new case of septic arthritis and provides insight into the people who guarded the royal tombs in the West Han Dynasty. The skeleton is not well-preserved, limiting observations of bony changes to other areas of the body.