Pediatrics : the hygienic and medical treatment of children . al symptomsmay not be present. In rapid cases death from general sepsis mayoccur in three or four days, but the disease is generally prolongedfor one or two weeks. DIAGNOSIS.—The differential diagnosis is to be made chieflyfrom the articular form of rheumatic fever, from which it is to be 374 Diseases of the Bones, Joints and Muscles distinguished by the surrounding soft parts being much less involvedand the general symptoms much more severe in osteomyelitis, and,if the disease occurs in the first two years^ by the rarity of rheumat
Pediatrics : the hygienic and medical treatment of children . al symptomsmay not be present. In rapid cases death from general sepsis mayoccur in three or four days, but the disease is generally prolongedfor one or two weeks. DIAGNOSIS.—The differential diagnosis is to be made chieflyfrom the articular form of rheumatic fever, from which it is to be 374 Diseases of the Bones, Joints and Muscles distinguished by the surrounding soft parts being much less involvedand the general symptoms much more severe in osteomyelitis, and,if the disease occurs in the first two years^ by the rarity of rheumatismat so early a period. From tuberculosis, osteomyelitis is to be differentiated by the slowonset of the former, and by the fact that the primary lesion generallyshows itself in the shaft of the bone in the latter, while in the formerthe epiphysis is usually first attacked. The process of osteomyelitis,may, however, attack the epiphysis and extend to the joint. of a leukocytosis in osteomyelitis is also of great aid inthe diagnosis. Fig. 25s. Osteomyelitis of the humerus PROGNOSIS.—The prognosis is very unfavorable unless imme-diate and radical surgical interference is carried out. TREATMENT.—The treatment is essentially surgical. Whenosteomyelitis of the shaft of a long bone is found at operation, allof the affected portions should be removed, even if a considerableportion of the shaft is taken, experience having shown that new bonewill soon form, and that a serviceable limb is the usual result in theleg and forearm.
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatr, bookyear1917
