. Roentgen interpretation; a manual for students and practitioners . ii_i Fig. 36.—Types of specific periostitis of the tibia;. Irregular areas of destruction may occur in any bone, usually asa result of gummatous changes. In the skull the picture is strikingand represents punched-out areas involving borh the outer and innertable. In the long bones they are usually associated with periostealchanges, although at times a bone may be riddled with these areas ofrarefaction and show only slight periosteal change. This is partic-ularlv common in the more acute cases. In children a common picture 60
. Roentgen interpretation; a manual for students and practitioners . ii_i Fig. 36.—Types of specific periostitis of the tibia;. Irregular areas of destruction may occur in any bone, usually asa result of gummatous changes. In the skull the picture is strikingand represents punched-out areas involving borh the outer and innertable. In the long bones they are usually associated with periostealchanges, although at times a bone may be riddled with these areas ofrarefaction and show only slight periosteal change. This is partic-ularlv common in the more acute cases. In children a common picture 60 BONE PATHOLOGY is the so-called jiixta-epiphyseal lesion, which occurs in the diaphysisnear the epiphyseal line. They are characterized at first by anirregular loss of substance close to the epiphyseal line and perhapsa slight periostitis. The affected area later becomes sclerosed, lead-. FiG. 37.—Specific periostitis (congenital type). ing to the formation of a white line, which resembles seen in scorbutus. Joint lesions may be unilateral or symmetrical. Ordinarily littleis seen beyond an increase in density in the soft parts, due to TYPHOID 61 effusion and synovial thickening. Later on, low rounded hyper-trophic growths may appear about the margins of these destructi\e processes may sometimes occur in the epiphy-seal ends of bones, causing considerable deformit}. Localized areasof destruction suggesting tuberculosis may sometimes be found inthe epiphyses of children.
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