. Diseases of bones and joints . arrow, the mar-row of the cortex, or the periosteum. Sometimesall three suffer. A frequent result of the morbidprocess is the formation of larger or smaller col-lections of a mucilaginous material and the localSyphilis destruction of the bone. Around this collection ofAffects dead bone and mucilaginous material the bone mayMarrow be sclerosed. Sometimes in the interior of theIm bone these collections may attain the size of a they lie near the surface they may becomesecondarily infected, forming abscesses, whichlater burst, and communicate with the surf
. Diseases of bones and joints . arrow, the mar-row of the cortex, or the periosteum. Sometimesall three suffer. A frequent result of the morbidprocess is the formation of larger or smaller col-lections of a mucilaginous material and the localSyphilis destruction of the bone. Around this collection ofAffects dead bone and mucilaginous material the bone mayMarrow be sclerosed. Sometimes in the interior of theIm bone these collections may attain the size of a they lie near the surface they may becomesecondarily infected, forming abscesses, whichlater burst, and communicate with the surface. Acommon situation for them is immediately under-neath the periosteum. The openings of the sinuses (180) DISEASES OF BONES AND JOINTS 181 upon the surface are wont to be dark red, under-mined and ragged, not pale and puffy as is thecase with tuberculous sinuses. What gives to syph-ilitic disease of the shafts its peculiar and almostdiagnostic appearance is the thickening of theperiosteum—a production of new bone, sometimes. Fig. myelo-periosteitis, hereditary. spindle shaped and sometimes more diffuse, andextending for a considerable distance. This bonythickening may be very painful. Especially incongenital syphilis the tibiae become thickened andcurved anteriorly, taking on a peculiar sabershape. Saber Tibiae 182 DISEASES OF BONES AND JOINTS Another and rarer effect of congenital syphilisis an irregularity of the epiphyseal line. It istoothed and notched instead of being straight orslightly arched. Occasionally disease in the neigh-borhood of the epiphyseal line causes a dislocationof the Congenital syphilis is also responsible for the Dactylitis fairly frequent disease of the metacarpals and pha-langes, and a condition results hardly to be distin-guished from tuberculous dactylitis. Secondaryinfection and sinus formation is frequent in thissyphilitic dactylitis, and a portion of the end ofone or more of the finger bones may be destroye
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