File:The American journal of roentgenology, radium therapy and nuclear medicine (1906) (14570521707).jpg

Identifier: americanjournroen06ameruoft (find matches)
Title: The American journal of roentgenology, radium therapy and nuclear medicine
Year: 1906 (1900s)
Authors: American Radium Society American Roentgen Ray Society
Subjects: Radiotherapy X-rays
Publisher: Springfield, Ill. C.C. Thomas
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: University of Toronto

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of Densk Bone,Medullary Canal Obliterated, Sequestrum atLower End. osteomyelitis is bone destruction with butlittle new bone production. In chronicosteomyelitis the conditions are exactlyreversed. We have excessive bone repro-duction with a few small areas of destruc-tion. The entire bone is thickened, fre-quently to such an extent that the medul-lary cavity seems to be completely ob-literated (Fig. 6). The bone is often irregu-lar in shape and much thickened, due toextensive deposition of periosteal boneuiion the cortex. In tlie hone there mav be Osteomyelitis 263 small areas due to little focal spots of in-fection. From this brief description it willbe readily seen that we have no one definiteroentgen ray picture, but that the changeswill depend entirely upon the virulence ofthe infection, the stage of the disease andthe resistance of the patient. The followingpoints must always be carefully noted: 1. The place where the infection starts. 2. The character of the destructiveprocess.
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Fig. 7. Entire Shaft is a SEyuEsiiuM, Dense New-Bone Forming Involucrum. Now ready to beoperated upon. 3. The path of e.\tension, that is,spreading equally in all directions orfollowing the path of least resistance. 4. The character and situation of newbone production. 5. The condition of the cortex, whetherit is intact, destroyed as a whole orpierced by sinuses, expanded or not. Thus far we have discussed only the infections arising from pyogenic organisms.We have one infection of constitutionalorigin which is extremely common, namely,luetic osteomyelitis. In this condition thechanges are fretjuently identical with thoseof pyogenic origin. There are two points,however, that assist us in making a correctdiagnosis. First, the lesions are generallyobserved in more than one bone; andsecond, the clinical picture does not coin-cide with that given by the roentgen ray.In lues the plate may show an apparentlyvery acute osteomyelitis, evidenced byextensive destruction, the entire bone beingin

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