. Diseases of bones and joints . Fig. 93. Skiagram of bone shown in Fig. 6. Diagnosis, sarcoma. symptoms and physical signs of this disease willmake the nature of the process evident. The bonelesions of tabes are almost invariably Myeloma. From the fact that this disease 216 DISEASES OF BONES AND JOINTS has been included hitherto with sarcoma, the differ-ential diagnosis is still somewhat obscure. It usuallyoccurs in the metaphysics of the long bones. Egg-shell crackling is frequent over it. It is prob-ably slower in its growth than is sarcoma, anddoes not break through into th
. Diseases of bones and joints . Fig. 93. Skiagram of bone shown in Fig. 6. Diagnosis, sarcoma. symptoms and physical signs of this disease willmake the nature of the process evident. The bonelesions of tabes are almost invariably Myeloma. From the fact that this disease 216 DISEASES OF BONES AND JOINTS has been included hitherto with sarcoma, the differ-ential diagnosis is still somewhat obscure. It usuallyoccurs in the metaphysics of the long bones. Egg-shell crackling is frequent over it. It is prob-ably slower in its growth than is sarcoma, anddoes not break through into the surrounding tissues. Fig. 95. Photomicrograph of portion! of shaft of bone shown inFigs. 6 and 7. A typical round cell sarcoma. Note the multitudeof small round cells replacing the normal marrow, and the markedabsorption of the bone. The occurrence of fracture can be under-stood easily. until very late if at all. The diagnosis may be im-possible until the time of operation. Then the cur-rant jelly appearance, possibly mottled with lighterareas, and theSchmierkase consistency will pointto the nature of the growth. If any doubt remains, DISEASES OF BONES AND JOINTS 217 the examination of a frozen section will reveal largenumbers of giant cells. Prognosis. This is bad, doubly so if involve-ment of the surrounding tissues have taken almost invariably occur under any formof treatment. Treatment. The best treatment probably consistsof amputation. The operation should be not anamputation through the affected bone, but a dis-articulation above it. CARCINOMA. Carcinoma in bone occurs only as a met
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