American practice of surgery : a complete system of the science and art of surgery . e changes are included, troplwneurotie atrophy andirritative hypertrophy proceeding perhaps simultaneously and side by side, andin this way producing the characteristic deformities. Inasmuch as these changesoccur primarily in the bones, the entire disease is to be distinguished from ar- Fig. — Ostitis Deformans (PagetsDisease) with Osteophytes and of a woman of forty, (von Reck-linghausen.) 362 AMERICAN PRACTICE OF SURGERY thritis deformans, in which the pathological processes commence
American practice of surgery : a complete system of the science and art of surgery . e changes are included, troplwneurotie atrophy andirritative hypertrophy proceeding perhaps simultaneously and side by side, andin this way producing the characteristic deformities. Inasmuch as these changesoccur primarily in the bones, the entire disease is to be distinguished from ar- Fig. — Ostitis Deformans (PagetsDisease) with Osteophytes and of a woman of forty, (von Reck-linghausen.) 362 AMERICAN PRACTICE OF SURGERY thritis deformans, in which the pathological processes commence rather withinthe joint structures, and in which the osseous changes are quite the bones of the head are most involved, they are usually those of theface. The thorax becomes more or less cubic in form, the arms perhaps rela-tively too long, the ribs increased in size, while the pelvis may be patellae are also enlarged, the tibia become more massive and their curvesmore exaggerated. Save in those rather exceptional instances above alluded m k 1 f \Mm. Fig. 160.—So-called Ossified Man. Osteoarthritis with True Ankylosis of nearly All the Joints.(From the Park Collection in the Museum of the University of Buffalo.) o. Front view; b, side view. to, where the disease seems local, it is essentially a symmetrical series of lesionswhich begin, as often perhaps as anywhere, in the cranium and ribs. In ostitis deformans fractures are rare, since the bones are hardened andstrengthened rather than weakened as the result of the sum of the majority of patients suffer more or less severe pain, often aggravated bypressure. In the earlier stages, at least, the disease is quite likely to begrouped with many other bone diseases as so-called rheumatism. Its mostconspicuous features are, briefly, deformity, with final crippling, and the painwhich it produces. (Fig. 160.) There remain vet to be mentioned in this connection the other bony changes NON-INFLA
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