. The American journal of roentgenology, radium therapy and nuclear medicine . Fig. 4. Case IV. Bilateral healed osteochondritis delornLins juvenilis. Served in world war. tion, which are so common after tubercu- the epiphysis is progressive, being slight at lous hip-joint disease, do not occur. hrst, and increasing till the epiphysis loses The roentgenogram, when once seen, is its rounded outline and is reduced to a very typical, so much so that most writers flattened plate or disc, often divided into 704 Osteochondritis Deformans Juvenilis several segments. Later these appear tofuse, and the
. The American journal of roentgenology, radium therapy and nuclear medicine . Fig. 4. Case IV. Bilateral healed osteochondritis delornLins juvenilis. Served in world war. tion, which are so common after tubercu- the epiphysis is progressive, being slight at lous hip-joint disease, do not occur. hrst, and increasing till the epiphysis loses The roentgenogram, when once seen, is its rounded outline and is reduced to a very typical, so much so that most writers flattened plate or disc, often divided into 704 Osteochondritis Deformans Juvenilis several segments. Later these appear tofuse, and the whole is finally united to thediaphysis. There is no hazing or cloudingof the joint. The upper part of the femoral neck isseen to iaroadcn, and becomes, as it were,rounded off. Coincident with this broaden-ing there is a gradual shortening of the neckas a whole and an increased density(eburnation). At first sight the angle ofincfination between the neck and shaftof the femur would appear to be lessened,with the development of consequent coxa. fPAM^ Fig. 5. Case V. Healed osteochondritis deformansjuvenilis. Served in world war. Note the almostperfect articulating surfaces. vara deformity. This was originally empha-sized by Calve, and in other earlier contri-butions in the hterature was regarded asindicating true coxa vara. But it is nowgenerally conceded that there is no actualbending of the neck, but that the depres-sion is apparent and not real. Most of the writers on this subject tendto regard the acetabular changes as rela-tively inconspicuous, unimportant or actu-ally non-existent. Perthes states that theacetabulum shows no deformation exceptin very advanced cases. Sundt, howc\cr,writes that in the later stages the aceta-bulum is normal. Swartz describes latechanges which he classifies as hypertrophic,and secondary to changes in the declares that osseous changes in theacetabulum can be seen at everv stage of the disease and that they should be con-sidered partly
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