. American quarterly of roentgenology . with more certainty by the radiograph than by clinicalmethods, but the radiograph in addition presents certain othercharacteristic features, otherwise undeterminable during life,besides those appearances which represent the generally recog-nized typical clinical and pathological features. The radiographic diagnosis is concerned solely with theexamination of the bones of the extremities, and depends uponthe unusual appearances presented by characteristic abnor-malities in their growth and development. Although prac-tically all of the bones of the extremit
. American quarterly of roentgenology . with more certainty by the radiograph than by clinicalmethods, but the radiograph in addition presents certain othercharacteristic features, otherwise undeterminable during life,besides those appearances which represent the generally recog-nized typical clinical and pathological features. The radiographic diagnosis is concerned solely with theexamination of the bones of the extremities, and depends uponthe unusual appearances presented by characteristic abnor-malities in their growth and development. Although prac-tically all of the bones of the extremities show some percep-tible alterations, the most characteristic features are presentedby those which grow or develop to a large extent from theirepiphyseal ends. The diagnosis is therefore easiest duringchildhood, when ossification in the epiphyses of the humerus,femur, and tibia is normally well advanced. During adult lifeit is somewhat more difficult for the reason that only theresults of abnormal development are to be observed. The. Fig. 1—Lower extremities of a case of Achondroplasia. Male, agedfifteen and one-half years. Pancoast: X-ray Diagnosis greatest difficulty is to be encountered during infancy, befossification in the epiphyseal extremities of these bones is faradvanced normally. At any age, however, characteristicappearances will be presented by some bones of the extremi-ties. The conditions with which achondroplasia are likely to beconfused, radiographically as well as clinically, are cretinismand rickets, and the essential points of difference between theskiagraphic appearances of each of the three diseases will beindicated as each of the characteristic radiographic features ofachondroplasia is discussed. Cretinism presents fewer characteristic radiographic fea-tures than achondroplasia, and the X-ray diagnosis of theformer condition by itself is, therefore, more difficult, but adistinction between the two can be very readily made. Unfor-tunately the statements
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