. Roentgen interpretation; a manual for students and practitioners . Fig. 33.—Tiiherculous spine (lateral view the epiphyseal end of the humerus. There is no bone atrophy; onthe contrary, there may be slight increase in density in the affectedarea. Dactylitis (spina ventosa) is characterized by considerableincrease in the diameter of the diseased phalanx, which showsextensive areas of destruction in the medulla. The cortex may be SYPHILIS 57 somewhat thin or sHghtly mcreased in thickness. This conditionis differentiated from syphiHtic dactyUtis by the fact that theenlargement in the latter is
. Roentgen interpretation; a manual for students and practitioners . Fig. 33.—Tiiherculous spine (lateral view the epiphyseal end of the humerus. There is no bone atrophy; onthe contrary, there may be slight increase in density in the affectedarea. Dactylitis (spina ventosa) is characterized by considerableincrease in the diameter of the diseased phalanx, which showsextensive areas of destruction in the medulla. The cortex may be SYPHILIS 57 somewhat thin or sHghtly mcreased in thickness. This conditionis differentiated from syphiHtic dactyUtis by the fact that theenlargement in the latter is due to periosteal proliferation with theformation of a collar of new bone outside of the old cortex; there is\QT\ little involvement of the medulla and from giant-celledsarcoma bv the absence of Fig. 34.—Crauial tub Syphilis. — Syphilis is a destructive and proliferative process,assuming ^•aried which may simulate other conditions. Itattacks any bone at any age. Its commonest manifestations areperiostitis and irregular areas of destruction. Periostitis is usually limited to the shaft, and the picture whichresults from it varies according to the age and activity of theprocess. ^Yhen acute the appearance is that of multiple distinct,thin laminse laid do^^m upon the old cortex, and the outline of thefree margin is usually irregular. As the condition becomes morechronic these laminae become thicker and more compact, so that 58 BONE PATHOLOGY ultimately the area involved becomes as dense as the normal the same time the surface loses its fringy character and becomessmooth, although it may be more or less irregular. This increase inthickness of the cortex will often give an appearance of bowing, as isseen in the so-called sabered tibia, for example. It should
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