. Radiography, X-ray therapeutics and radium therapy . tract, etc. It is generally a latesecondary manifestation, the bones most frequently affected being the ster-num, ribs, and spine. The disease may also invade a large joint, or the shaftsof the long bones become involved. The sacrum or iliac bones may also be DIFFERENTIAL DIAGNOSIS OF TUMOURS OF BONE 185 invaded. The presence of these secondary deposits is shown radiographicallyby rounded irregularshadows of varyingdensity, generally lighterthan the normal other cases the diseasetakes the form of cario-necrosis, when cavitiesfilled
. Radiography, X-ray therapeutics and radium therapy . tract, etc. It is generally a latesecondary manifestation, the bones most frequently affected being the ster-num, ribs, and spine. The disease may also invade a large joint, or the shaftsof the long bones become involved. The sacrum or iliac bones may also be DIFFERENTIAL DIAGNOSIS OF TUMOURS OF BONE 185 invaded. The presence of these secondary deposits is shown radiographicallyby rounded irregularshadows of varyingdensity, generally lighterthan the normal other cases the diseasetakes the form of cario-necrosis, when cavitiesfilled with necrosed tissueare produced, and ap-pear on the screen orplate as lighter areas. Exostoses.—Theseshow as projections,sometimes of normalbone tissue, and some-times of rarefied orunusually dense bone ;the situations in whichthey are met with arenumerous, as in the endsof the long bones, bonesof the feet, the pubis, etc. Chondromata.—These may occur in any bone, but particularly in thelong bones, and also in the bones of the fingers and Fig. 151.—Exostosis of lower end of femur. Shows signs ofinflammatory changes at end of exostosis, probably secondaryto trauma. Differential Diagnosis of Tumours of Bone A brief summary of the commoner forms of tumour of bone and of thepoints which are most useful in diagnosis is necessary. It is also well toremember that there are no positively definite signs of any particular data and radiographic records should be taken together if theexamination is expected to be of value. The appearance of a shadow of doubtful nature in one of the long bonesraises most important questions of diagnosis. The benign cyst has recentlybeen shown to be a comparatively common tumour of bone. The termbenign is used in relation to the degree of malignancy and growth rather thanas a pathological classification. Many of these so-called benign growths aremyeloid sarcomata, which are peculiarly slow in the rate of growth. Thetumours most
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