American practice of surgery : a complete system of the science and art of surgery . , an actual thick-ening of the bone cortex and a ring of bone about the osteomyelitic cavity,which is more resistant to the passage of the j-rays tlian the rest of the shaft. The sequestra found are often large and of considerable x-rixy density. The two processes resemble each other in that they are both destructiveat some stage, and also in the fact that at times they exliibit the character-istics of an almost malignant process, sliowing a tendency to fresh outbreaksafter very long periods of apparent cure.
American practice of surgery : a complete system of the science and art of surgery . , an actual thick-ening of the bone cortex and a ring of bone about the osteomyelitic cavity,which is more resistant to the passage of the j-rays tlian the rest of the shaft. The sequestra found are often large and of considerable x-rixy density. The two processes resemble each other in that they are both destructiveat some stage, and also in the fact that at times they exliibit the character-istics of an almost malignant process, sliowing a tendency to fresh outbreaksafter very long periods of apparent cure. 650 AMERICAN PRACTICE OF SURGERY. In considering the .r-ray evidences of osteomyelitis, it is perhaps betterto describe types ratlier than stages, for osteomyehtis is a disease of so greatlyvarying an etiology that it possesses no typical stages. (1) There is a type of acute circumscribed osteomyelitis which it is oftendifficult to distinguish clinically from tuberculosis. The solution of the dif-ficult v constitutes one of the most satisfactory .r-ray diagnoses, for in this case. Fui. 221.—Osteomyelitis. Femoral neck on the right side snows new bone deposit along outer involvement of articular surface. No atrophy of shaft. (Original.) the dictum of the method is almost absolute and the sim])lification of treat-ment in the way of operative measures is very great. The disease is compara-tively common. In all the cases of this nature that we have seen, a pure culture of eitherthe Staphylococcus ])yogenes aureus or the Staphylococcus i^vogenes albushas been obtained. The lesions which thev cause are the small localized cavities THE INTERPRETATION OF RADIOGRAPHS. 651 or bone furuncles. They are often chronic in character, and at times are accom-panied by little external evidence of the bone process. In the radiograph thesmall single or multiple cavities are, as a rule, easily seen, but in certain positionsthey are obscured by an overlying cortex. They occur connnonly near
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