. American quarterly of roentgenology . n the apparent shorteningdue to the usual deformities or bowing is duly , the shafts do not present the decided lack of devel-opment as compared with the ends that is so characteristic ofachondroplasia. 2. All of the long and short long bones of the extremities,although actually thinner than normal, are relatively thickfor the lengths of their shafts. This is radiographic evidencethat periosteal growth is not affected to nearly the sameextent in this disease as is epiphyseal development of theshafts. In the cretin the thickness is near
. American quarterly of roentgenology . n the apparent shorteningdue to the usual deformities or bowing is duly , the shafts do not present the decided lack of devel-opment as compared with the ends that is so characteristic ofachondroplasia. 2. All of the long and short long bones of the extremities,although actually thinner than normal, are relatively thickfor the lengths of their shafts. This is radiographic evidencethat periosteal growth is not affected to nearly the sameextent in this disease as is epiphyseal development of theshafts. In the cretin the thickness is nearly or quite in the properproportion to the length of the shafts. The middle of theshafts, particularly of the tibia and femur, is apt to be foundconsiderably thinner than normal, but toward their ends thediameter. gradually increases to a width much nearer thenormal. This might be accepted as radiographic evidence thatdeficiency in development from epiphyseal ends is not anessential pathologic feature in cretinism as in Fig. 3—Achondroplastic male, aged fourteen months. Pancoast: X-ray Diagnosis 93 In rickets the thickness of the shafts is not to any greatextent out of proper proportion to their actual lengths, par-ticularly in the case of the bones of the hands and feet. 3. Many of the long bones appear decidedly bowed. Thesedeformities tend materially to exaggerate the stunted appear-ance of the extremities for which the shortness of the bones isprimarily responsible. At least two factors in the productionof the bowing are demonstrable by the radiograph. It is per-haps most marked in the tibia and femur near their adjacentends, or immediately in the neighborhood of their respectivediaphyso-epiphyseal junctions. In these localities the deformi-ties appear to be largely the result of irregularity as well asdeficiency in development and ossification. A second but lessimportant or characteristic factor is usually best demonstrablein connection with the bowing o
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