Practical podiatry : . value as an aid to diagnosis. Ifa condition involves the bony structure of the foot, clinicalsymptoms are never so certain that an absolutely positivediagnosis can be made, but the X-ray plate readily revealssuch disturbances so that there is no doubt left in the mindsof the practitioner as to the exact nature of the , exostosis, fractures, arthritis, bone abcesses,bone ulcers, etc., are thus easily distinguished. Periostitis. Periostitis is an inflammation of the peri-osteum, the outer covering of the bone. There are two types,the acute and the chroni
Practical podiatry : . value as an aid to diagnosis. Ifa condition involves the bony structure of the foot, clinicalsymptoms are never so certain that an absolutely positivediagnosis can be made, but the X-ray plate readily revealssuch disturbances so that there is no doubt left in the mindsof the practitioner as to the exact nature of the , exostosis, fractures, arthritis, bone abcesses,bone ulcers, etc., are thus easily distinguished. Periostitis. Periostitis is an inflammation of the peri-osteum, the outer covering of the bone. There are two types,the acute and the chronic, both of which are not reallydiseases themselves, but are indications of the reaction ofthe periosteum to some irritant. In acute periostitis theX-ray plate shows a slight destruction of the outer portionof the bone, and a slight thickening of the periosteum, andif suppuration is present, the lesion is a mild osteomyelitisrather than a periostitis. Chronic periostitis causes an increase in the osteogen- 398 iODIATHY. SPUR ON THE UNDER SURFACE OE THE HEEL X-RAYS IN PODIATRY 399 etic cells of the periosteum and is common in a great manylesions. Trauma, blows or contusions cause a chronicthickening of the bone-covering with additional bone forma-tion, as do syphilis and superficial abscesses in the softtissues, in the immediate vicinity of long bones. Thuschronic ulcer of the leg over the shaft of the tibia willproduce this condition. The picture shows that the evenline of the bone surface is lost, and there is a rough, unevenedge, with or without an increase in the bone cells. Theentire shaft of the bone is often thicker than normal, espec-ially in the metatarsals, and it is quite common to find oneof these bones greatly increased in size. The fourth meta-tarsal is the one most usually affected. Exostosis. This lesion is common in the foot, and is asource of great pain and annoyance. It is usually the resultof a chronic bursitis which has affected the periosteum overa localized
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