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CT Helps Solve Mysteries Of Richard III’s Spine

June 2, 2014
Written by: , Filed in: Diagnostic Imaging, Musculoskeletal Radiology
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CT scans have made possible the re-creation of one of the most famous spines in history: that of Richard III, king of England from 1483 to 1485 and the subject of one of the most scathing plays in Shakespeare’s canon.

Shakespeare devotes an entire play to the king’s perfidies. The character also appears villainously in some of the Bard’s other history plays. Phil Stone, a radiologist who is chairman of the Richard III Society, says the CT evidence provides “yet more proof that, while the plays are splendid dramas, they are also most certainly fiction, not fact.”

In the opening soliloquy of Richard III, the title character describes himself as “deformed, unfinish’d, … scarce half made up, and that so lamely and unfashionable that dogs bark at me as I halt by them.”

It turns out he merely suffered from scoliosis, or curvature of the spine. He was hardly the “bunchback’d toad” of Shakespeare’s description, according to osteoarchaeologist Jo Appleby, PhD, a lecturer in human bioarchaeology at the University of Leicester in Leicester, United Kingdom:

The condition would have meant that his trunk was short in comparison to the length of his limbs, and his right shoulder would have been slightly higher than the left, but this could have been disguised by custom-made armor and by having a good tailor.

Dr. Appleby was quoted in a university news release. She is lead author of an article analyzing Richard’s scoliosis that was published online on Friday in The Lancet.

Richard’s skeleton was excavated in 2012 at a parking lot that had once been the site of Greyfriars Church. Researchers made CT scans of the spine, then used a 3-D printer to create a polymer replica of each vertebra.

“The arthritis in the spine meant it could only be reconstructed in a specific way,” Dr. Appleby said, “meaning that we can get a very accurate idea of the shape of the curve.”

The researchers concluded that the scoliosis probably developed during adolescence and would not have reduced Richard’s lung capacity. The leg bones were “symmetric and well formed,” according to the Lancet article, so the king would not have limped.

“History tells us that Richard III was a great warrior,” said Dr. Stone, as quoted in the news release. “Clearly, he was little inconvenienced by his spinal problem, and accounts of his appearance written when he was alive tell that he was ‘of person and bodily shape comely enough.'”

A court ruling in May allowed plans to proceed for Richard’s reburial in Leicester Cathedral. Perhaps he can finally rest in peace, safely shielded from detractors either canine or human.

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Why do physicians order scans and other tests that seem unnecessary? Is it because of money? Or because of “care and commitment”? For one doctor’s poignant take on the issue, see our Facebook page.

Related CME seminar (up to 20.25 AMA PRA Category 1 credits™): Computed Body Tomography: The Cutting Edge

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