Tuberculosis in infancy and childhood : its pathology, prevention, and treatment . er portion of the dorsal spine is affected, the attitude isone of forward inclination of the body ; the shoulders are shrugged andsquare, and the head laterally deviated. If the lower part of the regionis diseased, the body is erect, the gait cautious, and the body will notbe bent forward. Pain is frequently present, and is often mistaken for stomach-ache. 12—2 180 TUBERCULOSIS IN INFANCY AND CHILDHOOD There is also a grunting respiration ; a growing tendency to stand withthe elbows resting on a chair or table ;
Tuberculosis in infancy and childhood : its pathology, prevention, and treatment . er portion of the dorsal spine is affected, the attitude isone of forward inclination of the body ; the shoulders are shrugged andsquare, and the head laterally deviated. If the lower part of the regionis diseased, the body is erect, the gait cautious, and the body will notbe bent forward. Pain is frequently present, and is often mistaken for stomach-ache. 12—2 180 TUBERCULOSIS IN INFANCY AND CHILDHOOD There is also a grunting respiration ; a growing tendency to stand withthe elbows resting on a chair or table ; an inability to rise from astooping position or pick an object from the floor without resting thehand on furniture or climbing up the limbs as in pseudo-hypertrophicparalysis (Fig. 7). Timid children can be placed across the separated knees of theparent, and by elevating one knee rigidity of the spine may be notedwithout giving alarm. If the child is put on a table to sit, it will notmove the body forward in the usual way. When deformity has takenplace the diagnosis is FIG. 6. -POSITION OF HEAD IX TUBERCULOSIS OF SPINE WHEN PATIENTIS PLACED IN PRONE POSITION. Paraplegia is more frequent in diseases of the upper dorsal spinethan elsewhere. It begins with exaggeration of the tendon reflexes,with stumbling, and goes on usually to complete paraplegia. Tuberculous Lumbar Spondylitis. After rigidity one of the earliest signs is increased lordosis. Itoccurs as a compensation to the psoas contraction so often is this deformity which leads to confusion between spondylitis andhip-disease. In the early stages the patients shoulders are thrownback, one foot is slightly advanced, and the patient walks with care,holding his spine rigid. In the latter stages the lordosis disappears ;the child bends his back forwards and walks with an obvious stoopfrom the pelvis. TUBERCULOSIS OF THE SPINE 181 Prognosis in Spondylitis of Tuberculous Origin. Prognosis may be considered as t
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