Tuberculosis in infancy and childhood : its pathology, prevention, and treatment . mpt be made to touch the head or toelevate the chin the child screams, but the head is held quite rigid. Ifthe two or three upper vertebrae are diseased the head will be twistedto one side as in wry-neck, one or both mastoids being rigid (Fig. 2).If the disease is lower, the chin is advanced and dropped towards thechest, and an angular projection at the point of disease will be noted TUBERCULOSIS OF THE SPINE J79 (Fig. 3). If the disease be still lower, the chin is raised and the headis thrown back towards the r
Tuberculosis in infancy and childhood : its pathology, prevention, and treatment . mpt be made to touch the head or toelevate the chin the child screams, but the head is held quite rigid. Ifthe two or three upper vertebrae are diseased the head will be twistedto one side as in wry-neck, one or both mastoids being rigid (Fig. 2).If the disease is lower, the chin is advanced and dropped towards thechest, and an angular projection at the point of disease will be noted TUBERCULOSIS OF THE SPINE J79 (Fig. 3). If the disease be still lower, the chin is raised and the headis thrown back towards the raised shoulder (Fig. 4). The posterior muscles may be so contracted that they may be mis-taken for an abscess. Radiating pain of a neuralgic type following thecourse of the occipital and auricular nerves is present in a typicalcase. Young children may be very apprehensive of a strangersapproach, and in such a case the child may be placed across theparents knees in the prone position. It will be noted that the headwill not be allowed to dangle, however prolonged the examination,. FIG. 5. FIXATION OF HEAD IN TUBERCULOSIS OF THE SPIXE. and in the supine position he will not carry it forward as in the first actof rising (Figs. 5 and 6). The complications are abscess and paraplegia. Abscess pointseither at the back of the throat, or laterally, at the back of the sterno-mastoid ; paraplegia is comparatively rare, and may affect both theupper and lower extremities. Tuberculous Dorsal Spondylitis. If the upper 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 elbo
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