. American quarterly of roentgenology . TEO-MYELITIS. Osteo-myelitis is diagnosed by the Roentgen-ray whendistinct pathological changes in bone have occurred. Thismay require some time; the older the lesion the more easy isthe Roentgen diagnosis. This affection is usually due toinfection but often follows extension of a periostitis andostitis. It is confined to bone and does not invade the softtissues excepting through sinus formation or breaking downof tissues through continuity of inflammation. Osteo-myelitis presents four points for Roentgen diagnosis: 1. Ossifying periostitis and ostitis.
. American quarterly of roentgenology . TEO-MYELITIS. Osteo-myelitis is diagnosed by the Roentgen-ray whendistinct pathological changes in bone have occurred. Thismay require some time; the older the lesion the more easy isthe Roentgen diagnosis. This affection is usually due toinfection but often follows extension of a periostitis andostitis. It is confined to bone and does not invade the softtissues excepting through sinus formation or breaking downof tissues through continuity of inflammation. Osteo-myelitis presents four points for Roentgen diagnosis: 1. Ossifying periostitis and ostitis. 2. Sclerotic changes. -*). Abscesses and cavities. 4. Sequestra of bone. The shaft of the distal end of bones is the favorite are found centrally located, circumscribed, clear spaces(cavities) with surrounding darkened areas (due to ostitis)and coincident periosteal enlargement, sometimes destructionand darkened shadows of same. Sequestra of bone whenpresent can be readily located and abscess and sinus formation Wo n> o 3. DlEFENBACH : DIAGNOSIS 1?1 determined—the latter by means of the Bismuth injectionmethod. In chronic cases of osteo-myelitis the myelogenous - o portion of bone shows a darker and enlarged shadow owingto sclerosis. Osteo-myelitis is distinguished from sarcoma from the factthat the latter invades surrounding soft tissue while theformer is confined to bone. Osteo-myelitis is a destructiveprocess; sarcoma a proliferating process. Sarcoma prefersthe extreme ends of the shafts of bone and commences as asubperiosteal growth, excepting in the giant cell variety whichusually starts in the medulla. In advanced cases of osteo-myelitis, the diagnosis is very easy as necrosis, caries, cavitiesand sequestra of bone can be readily noted. OSTEO-MALACIA. Osteo-malacia is rendered easy of diagnosis by means ofthe Roentgen-ray. It may be suspected in cases of spon-taneous fractures (syphilis and osteoporosis must be excluded)but the characteristic Roentge
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