File:American practice of surgery - a complete system of the science and art of surgery (1906) (14782044012).jpg

Identifier: americanpractice03brya (find matches)
Title: American practice of surgery : a complete system of the science and art of surgery
Year: 1906 (1900s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914 Buck, Albert H. (Albert Henry), 1842-1922
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Publisher: New York : W. Wood and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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to the negative a cloudy appearance. The outline of thetumor is also apt to be indistinct and to blend with the soft parts. The cortexunder the periosteum appears rough, and in the osteoid form it is rarely thinned.In the medulla there may be a dark area indicating involvement. In the ad-vanced -tags one may distinguish dark areas representing cartilage or cysts,and light areas of bone or calcification. In the round- or spindle-cell sub-periosteal form the amount of newly formed bone is small, and the cortex is TUMORS ORIGINATING IN BONE. 449 rarefied or completely destroyed; while above or below the growth there maybe thickening due to the formation of new hone (Fig. LC9). The typical giant-cell sarcoma appears, in the radiograph, as a clear areasituated at the end of the bone and looking not unlike a cyst, but the outlinesare as a rule not as clearly marked, and, in many cases, fine trabeculse of boneextend across it. In the later stages there is distinct swelling, with thinning of
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Fig. 195. Small Round-cell Sarcoma of the Ulna. Note the bone destruction and pathological fracture. (Massachusetts General Hospital.) the cortex, the tumor as before appearing as a cavity with irregular walls, whichmay be partly absent when the growth has extended through into the softparts (Figs. 197 and 203). Central round- and spindle-cell sarcomata do not appear as well-definedencapsulated tumors. (Fig. 195.) The bone is gradually absorbed and hasa worm-eaten appearance, while in the later stages it may be entirely replaced by the tumor. vol. in.—29 150 AMERICAN PRACTICE OF SURGERY. It will thus be seen that, with the aid of the radiograph, which reveals thenormal appearance of the cartilage, joint affections such as the various formsof arthritis arc easily ruled out. Syphilitic joints (Charcots joints) showcomplete disorganization, with almost entire destruction of the ends of bothbones. Syphilis in some of the other forms is more difficult to exclude. Thetypical gumma of the

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