. Diseases of bones and joints . sesses a long,rounded, posterior curve, occasionally a more or 196 DISEASES OF BONES AND JOINTS General ^ess anSu^ar bend. The abdomen is prominent, theAppearance spleen is frequently enlarged. Anemia is always asymptom, probably on account of interference withthe blood-forming function of the marrow. Thepatients are pasty-looking and weak. Gastro-intestinal symptoms are wont to be marked, convul-sions and attacks of false croup occur in many Fig. Skiagram of hand and forearm. cases. Pain and sensitiveness of the epiphyses areoften observed. diagnos
. Diseases of bones and joints . sesses a long,rounded, posterior curve, occasionally a more or 196 DISEASES OF BONES AND JOINTS General ^ess anSu^ar bend. The abdomen is prominent, theAppearance spleen is frequently enlarged. Anemia is always asymptom, probably on account of interference withthe blood-forming function of the marrow. Thepatients are pasty-looking and weak. Gastro-intestinal symptoms are wont to be marked, convul-sions and attacks of false croup occur in many Fig. Skiagram of hand and forearm. cases. Pain and sensitiveness of the epiphyses areoften observed. diagnosis. The milder cases may occasion some difficulty,but the severer ones can be recognized at a has its acute, exquisitely painful swellings DISEASES OF BONES AND JOINTS 197 in the neighborhood of the joints, and its hemor-rhages into the gums and elsewhere. A mild de-gree of chronic hydrocephalus produces a changein the skull slightly resembling that of rickets, butit, like scurvy, lacks all the constitutional symp-. Fig. Skiagram of lower extremities (Osgood). toms of the latter. Osteopsathyrosis shows evi-dences of numerous fractures. PROGNOSIS. Rickets itself involves little danger to life, butchildren who suffer with it are prone to intercur-rent disease, and their mortality is rather high. Treatment Constitutional and Local 198 DISEASES OF BONES AND JOINTS TREATMENT. With our present knowledge, the treatment islargely constitutional. Attention to the diet, andplenty of fresh air are essential. Cod liver oil hasbeen praised. The lime preparations are probablynot of much value. A child with severe ricketsshould be kept off his feet as much as possible, inorder to prevent deformity. Braces and manipula-tions are very valuable for curing the deformities,as long as the bones are soft—roughly up to 4 yearsof age. When the bones become sclerosed, allapparatus is useless. For the severe deformitiesoperation is usually necessary, but never while thebones
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