This study is an attempt to correlate a macroscopic bone pathology, cribra orbitalia, with an amino acid residue analysis (AARA) of the Type I collagen from that same pathology. It has been noted in some studies that the imino acid found in collagen, hydroxyproline, is quantitatively reduced when examined from an individual showing these lesions. Previous studies have used small samples to make this determination. By expanding the sample size and utilizing a sample with a documented dietary history, a differential diagnosis of cribra orbitalia can be made. The sample tested in this thesis consists of 40 individuals from a Romano-Christian Period tomb (DK-31) at the Dakhleh Oasis, Egypt.

The remains are visually assessed for cribra orbitalia, an orbital manifestation of porotic hyperostosis, purported to be an indicator of anemic stress. Collagen extracted from the orbital lesions are subjected to AARA. This provides not only an evaluation of the diagenetic environment, but also indicates that as a group, the individuals were under an anemic stress, confirming the etiological hypothesis in other studies. A comparison of these data to the "severity" of the lesions demonstrates that there is no relationship between the "severity" or visual scale of assessment to the hydroxyproline level.

The differential diagnosis of cribra orbitalia in this sample considers not only the amino acid data, but also the archaeological context. The combination of a skeletal analysis, amino acid analysis, and other palaeodietary studies leads to the conclusion that a likely deficiency of iron is indicated. The differential diagnosis excludes the genetic anemias, such as thalassemia, sickle cell anemia, and G6PD due to a lack of pathognomonic skeletal lesions. The amino acid analysis suggests that all individuals suffered from a lack of iron. This lack of iron is also evidenced in the orbital lesions of neonates.

The study concludes that amino acid residue analysis conducted on well preserved remains can aid in the differential diagnosis of skeletal lesions in past populations. However, it should be used as a diagnostic aid and not the sole criterion for determining the epidemiological nature of cribra orbitalia and porotic hyperostosis.