Identifier: diseasesofbonesj00elyl (find matches)
Title: Diseases of bones and joints
Year: 1914 (1910s)
Authors: Ely, Leonard Wheeler, 1868-
Subjects: Bones Joints Diagnosis, Radioscopic Bone Diseases Joint Diseases Radiography
Publisher: New York : Surgery Publishing Company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ent ismost eager to keep the limb quiet, motion in the .neighboring joint is but slightly restricted. Theedema of the limb is characteristic. Tuberculous inflammation of the shaft marrowis very rare, and is decidedly slower in its course. Syphilis, typhoid and gonorrheal marrow in-flammations are not so destructive, nor so rapid,nor is the constitutional involvement so severe, asin suppurative myelitis. If we will steer clear of the error of calling any deep-seated disease in the extremities rheuma- ,, ! - 1 . . , i-i the Term tism and dosing the patient with salicylates as a routine measure, we shall usually not be very long in reaching a correct diagnosis. The thickened shaft, the discharging sinuses, etc., make the later stages quite plain. Rheumatism 174 DISEASES OF BONES AND JOINTS PROGNOSIS. This is usually good if the disease be recognizedearly, and if proper treatment be carried out, badotherwise. Death may quickly result from septi-cemia. The mechanical obstruction to healing
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Fig. 74.Suppurative osteomyelitis, circumscribed form (Osgood). caused by the presence of dead bone or by Naturesunaided efforts to repair the damage, may resultin a suppurating cavity that may persist for years.The dense eburnated bone walling off the diseasedarea from the rest of the shaft may prevent nor-mal bone production, and the union of the two ends DISEASES OF BONES AND JOINTS 175 of the bone. Two eburnated bone ends seldom ifever unite spontaneously, probably because they arepractically without marrow. Nichols maintainsthat if the sequestrum be allowed to remain toolong the periosteal bone is incapable of filling thegap. TREATMENT. For the circumscribed forms, incision and drain-age constitute the best treatment. For the diffuse form incision and drainage are Methodour first care also, but here we must remember that 0f Operatingwhen we have incised the periosteum and have letout a collection of pus under it, our task, exceptin the most superficial cases, is only begun. Wemus

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