. The American journal of roentgenology, radium therapy and nuclear medicine . parated from the diaphysis ofthe femur and the epiphysis of the greatertrochanter. The bone destruction from line of the trochanter extendedon the diaphysis for approximately i cm.,ending in a spur of elevated bone i cm. inheight. There was no change in theacetabelum or head of the femur. Theepiphyseal line for the head of the femurwas normal. In the soft structures above the righttrochanteric epiphysis there is a shadow Tubercular Epiphysitis of the Greater Trochanter 55* the size and shape of a norm
. The American journal of roentgenology, radium therapy and nuclear medicine . parated from the diaphysis ofthe femur and the epiphysis of the greatertrochanter. The bone destruction from line of the trochanter extendedon the diaphysis for approximately i cm.,ending in a spur of elevated bone i cm. inheight. There was no change in theacetabelum or head of the femur. Theepiphyseal line for the head of the femurwas normal. In the soft structures above the righttrochanteric epiphysis there is a shadow Tubercular Epiphysitis of the Greater Trochanter 55* the size and shape of a normal kidney (21 •_>by 5 inches), which is much more densethan the surrounding soft structures, thoughmore radiable than the normal bone; thisshadow is probably a thickening of thedense fascia lata from infection. Roentgen Ray Diagnosis, i. Neoplasm,destructive sarcomata. 2. Osteomyelitis,probably tuberculous. Operation by Dr. B. F. Zimmerman onApril 22, 1921. The mass was incised andthe macroscopic appearance was that of adegenerated tumor. There was a thin turbid gJriv^. Fig. 3. Photomicrograph of greater trochanter of theepiphysis showing typical tubercles. (Signed) StuartGraves, pathologist. fluid in the fascial planes, which wasremoved, and a piece of the tissue wasexcised for microscopical study. The woundwas left open for the purpose of radiumapplication, should it prove tumor mass was disturbed as little aspossible. Clinical and Surgical Diagnosis. Degen-erated sarcomata. Microscopical examination by Graves and J. D. Allen showeda number of tubercles in almost all thesections. Diagnosis. Tuberculosis. On April 29, 1921, the boy was again sub-jected to operation. The incision was enlarg-ed and all the fungoid material bone was curetted and the woundpacked with iodoform gauze. The recoverywas entirely satisfactory, the wound heal-ing completely in three months time,there being very little discharge at anyperiod. The pathologists rep
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