A Swollen Legacy: The Byzantine Child Who Carried a Rare Bone Disease

The Child Beneath the Tetrapylon

In the ancient city of Aphrodisias, once a vibrant marble metropolis in southwestern Türkiye, archaeologists excavating a Middle Byzantine cemetery stumbled upon a small grave. Inside, nestled beside another child, lay the skeletal remains of a three-year-old who had lived and died around 900 years ago.

Left (upper) and right (lower) ulna comparison. Note the thickening of the left ulna. Credit: Başaran

To the casual observer, the bones might have seemed ordinary. But to Duru Yağmur Başaran, a bioarchaeologist studying childhood health in the Byzantine world, they told a very different story. Several bones were thickened, swollen, and oddly shaped. The jawbone, ulna, and shoulder blade all showed signs of inflammation, as if the child’s skeleton had waged a painful, uneven war within itself.

“This kind of pathological asymmetry is rare in archaeological contexts,” explains Dr. Eleni Fotopoulou, a paleopathologist at the University of Thessaloniki. “It suggests a systemic condition, one that shaped the child’s short life from the inside out.”

Başaran’s detailed analysis, published in Childhood in the Past,¹ identified the most likely cause as infantile cortical hyperostosis (ICH)—a rare disease better known to modern clinicians as Caffey disease.