. Roentgen interpretation; a manual for students and practitioners . Fig. 54. -Scurvy, well advanced. Case showing separation of the periosteum anddisplacement of the epiphysis due to hemorrhage. Scorbutus.—This condition is commonly seen during the firstyears of life and may or may not have an associated rickets. Theearliest evidence of its presence is a wiiite line in the shaft marginof the epiphyseal zone. This line is thinner, more dense and moresharply defined than the one seen in rickets. Later in the clinicalcourse subperiosteal hemorrhages appear as more or less extensiveirregular elev
. Roentgen interpretation; a manual for students and practitioners . Fig. 54. -Scurvy, well advanced. Case showing separation of the periosteum anddisplacement of the epiphysis due to hemorrhage. Scorbutus.—This condition is commonly seen during the firstyears of life and may or may not have an associated rickets. Theearliest evidence of its presence is a wiiite line in the shaft marginof the epiphyseal zone. This line is thinner, more dense and moresharply defined than the one seen in rickets. Later in the clinicalcourse subperiosteal hemorrhages appear as more or less extensiveirregular elevations of the periosteum over the entire length of the DISEASES OF NUTRITION 77 shafts of the long bones. In severe cases the hemorrhage may besufficient to produce separation of the epiphysis. The final processconsists of organization of the clot which produces a shadow ofconsiderable density about the Fig. 55.—Osteogenesis imperfecta. Differential diagnosis is from lues and osteomyelitis. Lues ismore apt to be a generalized process, the periosteum is less elevatedand epiphyseal dislocation does not appear. In osteomyelitis thereis destruction of the shaft which is unaffected in scorbutus, and theclinical picture is, of course, quite characteristic. 78 BOXE PATHOLOGY Achondroplasia (Chondrodystrophy Fetalis) .—The bones in thiscondition are shortened, compact and at times bowed. The epiphy-seal Hne is very thin and sharply defined and closes considerablyearlier than the normal. This results in an adult whose long bonesare very much shortened, with corresponding loss of weight. Thisprocess is said to involve only those bones in which ossification hasbegun before the sixth month.
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