American practice of surgery : a complete system of the science and art of surgery . equent fractures or bendings (Fig. 261). Acromegaly. In this disease there are enlargements of both the soft parts and the bonystructures; the enlargement of the latter, however, being only slight in addition, osteophytes may appear in the neighborhood of joints, but thearticular surfaces are, as a rule, free. A striking feature is the wide joint spaces.(See Fig. 262, and compare with Fig. 263, the latter being a case of giantism.) OsTEOARTHROPATHIE HyPERTROPHIAXTE PxErMKilK. This rare condition may


American practice of surgery : a complete system of the science and art of surgery . equent fractures or bendings (Fig. 261). Acromegaly. In this disease there are enlargements of both the soft parts and the bonystructures; the enlargement of the latter, however, being only slight in addition, osteophytes may appear in the neighborhood of joints, but thearticular surfaces are, as a rule, free. A striking feature is the wide joint spaces.(See Fig. 262, and compare with Fig. 263, the latter being a case of giantism.) OsTEOARTHROPATHIE HyPERTROPHIAXTE PxErMKilK. This rare condition may be confused with both syphililic disease and oste-itis deformans. It is said that there may be seen an outside less dense layer 686 a:\iericax practice of surgery. of noAvly formed periosteal bone all along the shaft. This layer of bone, whichhas a striated appearance, does not completely obscure the old cortical only radiogra]:)h at oiu* disposal shows this verj^ imperfectl^^ Elephantiasis name has been aj^plied to an enlargement of bones produced by perios-. FiG. 272.—Bone Atrophy. Anterior poliomyelitis. Bones on the left side show }^ of size, but little of structure. Leg iu constant use. (Original.) teal irritation. It occurs most markedly in cases in which there has been anantecedent sepsis. Congenital ^Malformations. A-ray plates may satisfactoril}- determine the l)ony depth of the acetabularcavity and the contour of the head of the femur in cases of congenital dislocationof the hip, and they readily differentiate this condition from an early coxavara, with which it is easily confused (Fig. 264). THE INTERPRETATION OF RADIOGRAPHS. 687 Obscure cases of torticollis will not rarely be found to have malformed,wedge-shaped vertebrae as their etiological basis, frequently associated withone or more cervical ribs (Fig. 265). Congenital elevation of the scapula may also be clearly demonstrated bythe x-ray plate (Fig. 266). The recent inve


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