The medical diseases of children . Fig. 13.—Rickets : Hot-cross-eun Head. is easily distinguished from this more serious disease by the absenceof rigidity, the spinal column becoming straight on extension, providedthe child is quiet and not resisting (Fig. 14). The long bones show many changes. The earliest is the enlargementof the lower radial epiphyses, those of the other bones being usuallyaffected later. As the result of crawling, walking, or even of beingcarried, the child may develop various curvatures usually more markedin the bones of the lower extremities than in those of the arms. Th
The medical diseases of children . Fig. 13.—Rickets : Hot-cross-eun Head. is easily distinguished from this more serious disease by the absenceof rigidity, the spinal column becoming straight on extension, providedthe child is quiet and not resisting (Fig. 14). The long bones show many changes. The earliest is the enlargementof the lower radial epiphyses, those of the other bones being usuallyaffected later. As the result of crawling, walking, or even of beingcarried, the child may develop various curvatures usually more markedin the bones of the lower extremities than in those of the arms. Thecommonest deformity is a sharp lateral curve in the lower part of thetibia, with which may be associated a forward bending of the shaft of RICKETS 67 the bone (Ftg. 15). Such may develop before the child can walk,from the cross-legged position adopted in sitting. Genu valgum is. Fig. 14.—Rickets : the Cats posture may lead to bending of the bones of the arms. very common. Less often there occurs the condition known as coxavara, in which bending occurs in the neck of the femur, so that thehead of the bone comes to lie aslow as the great trochanter, oreven at a lower level. The pelvismay be deformed in various ways,leading to a diminution of itscapacity. The bones of the armsmay become curved from the childputting its weight upon them whencrawling or sitting on the floor(Fig. 14). Fractures are may be considerable stunt-ing of the growth of the bones ofthe limbs in severe cases of System.—Rickets is acommon cause of a child going offhis legs. The muscles becomemuch weakened, so that the patientis no longer able to support hisweight upon them, although stillable to move them freely. At an earlier age,
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatrics, bookyear1
