Modern diagnosis and treatment of diseases of childern; a treatise on the medical and surgical diseases of infancy anf childhood . rapidly goes on to suppuration, leading to loosen-ing of the periosteum and bone necrosis and separation of the Diapbyso- diaphysis from its epiphysis. If the patient survives and the epiphyseal r r • separation, inflammatory process subsides, there is a separation of the dead hone (sequestrum) from the living. Unless removed the seques-trum may remain an everlasting source of irritation and sup-puration. NON-TUBERCULOUS OSTEOMYELITIS. 395 The osteomyelitic process


Modern diagnosis and treatment of diseases of childern; a treatise on the medical and surgical diseases of infancy anf childhood . rapidly goes on to suppuration, leading to loosen-ing of the periosteum and bone necrosis and separation of the Diapbyso- diaphysis from its epiphysis. If the patient survives and the epiphyseal r r • separation, inflammatory process subsides, there is a separation of the dead hone (sequestrum) from the living. Unless removed the seques-trum may remain an everlasting source of irritation and sup-puration. NON-TUBERCULOUS OSTEOMYELITIS. 395 The osteomyelitic process is ushered in by a chill, rapid riseof temperature and pulse and other symptoms which usually symptomsaccompany acute suppurative affections. Before the appearance ;of the local symptoms the disease is very apt to be mistaken for apyemic or typhoidal condition, and in infants unable to indicatethe presence of local pain osteomyelitis may end fatally beforea correct diagnosis has been arrived at. Hence the importanceof a careful examination of the bony system in all febrile affec-tions with indefinite Fig. 122.—Osteomyelitis of Tibia (2 weeks old). Compli-cated by Extension of Phlegmonous Inflammation to the Prepa-tellar Bursa. (Senn.) Excruciat-ing pain. The local symptoms of osteomyelitis are: Pain, tenderness,swelling, redness, synovitis, epiphyseolysis, and loss of function. The pain is excruciating, boring or throbbing, worse at night,and increases in intensity as the exudation becomes more abun-dant. Young children are rarely capable of locating the exact seatof the pain, but usually refer to the entire affected limb. As arule, the pain disappears suddenly with the escape of the inflam-matory products from the interior to the exterior of the bone. Tenderness on pressure can he detected early, and is most Tenderness 1 - on pressure. severe where the inflammation has approached nearest the surface of the bone. tenderness ( Whei in rear the disease


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Keywords: ., bookcentury1900, bookdecade1910, booksubjectchildren, bookyear191