. The American journal of tropical medicine. Fig. 1. Foot of Case 18 (Allison) The anterior portion of the os calcis is softened, its cancellous structureis largely lost and it contains numerous tortuous tunnels from 1 to 2mm. in diameter. There is a great increase in the amount of subcu-taneous connective tissue on the dorsum, which appears of a violetcolor. There are numerous tortuous sinuses, extending through theinvolved region, from 2 to 5 mm. in diameter, and with numerous cavern-ous expansions. They are deeply embedded in dense connective tis- MYCETOMA IX NORTH AMERICA 241 sue. They hav
. The American journal of tropical medicine. Fig. 1. Foot of Case 18 (Allison) The anterior portion of the os calcis is softened, its cancellous structureis largely lost and it contains numerous tortuous tunnels from 1 to 2mm. in diameter. There is a great increase in the amount of subcu-taneous connective tissue on the dorsum, which appears of a violetcolor. There are numerous tortuous sinuses, extending through theinvolved region, from 2 to 5 mm. in diameter, and with numerous cavern-ous expansions. They are deeply embedded in dense connective tis- MYCETOMA IX NORTH AMERICA 241 sue. They have a wall of varying thickness, not over 1 mm. and yel-lowish in color. There is an extension of the area of invasion on theanterior aspect of the ankle, the extension apparently taking placealong the fascial planes and is not marked externally in any way. Thesinuses are most numerous at either end of the metatarsal bones. Be-low the metatarsal phalangeal articulations a group of sinuses extend. Fig. 2. Sagittal Section of Foot of Case IS toward the {olantar surface. In the sinuses and their expansions aresmall granules, from to 1 mm. in diameter, lying either singly or inmulbeny like masses, whicli may (Mitiv(>l> fill the lumen of the are a diity white oi pale oclu-e in coloi-. The sinuses between thegranules appear to be filled with necrotic material. A few are filledwith a slightly opaque gelatinous material. A probe passed into thefoot through one of the openings into sole penetrates the diseased area 242 MARK F. BOYD AND EARL D. CRUTCHFIELD in the center of the foot. The joint surface between the third meta-tarsal and the inner cuneiform appears obhterated. Case 27 (Singleton). (Fig. 3, 4.) Left foot in good state of preser-vation. It has a swollen pufTy appearance, especially marked on theplantar aspect. The normal areas of concavity are all obliterated andreplaced by convexities. The toes are not swollen or spread reason of the plantar swe
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Keywords: ., bookcentury1900, bookdecade1920, booksubjecttropica, bookyear1921
