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When located in the shaft of a long bone, pathological fracture is liable to occur. Diagnosis and X-ray Appearances of Myeloma. The inflammatory lesions at the ends of the long bones tubercle, syphilitic gumma, and Brodie's abscess, that resemble myeloma, are all attended with the formation of new bone in greater or lesser amount.
New growths include the fibroma, the myxoma, the myeloma or giant-celled tumour, and various forms of sarcoma. #Diseases of Individual Bursæ.# The olecranon bursa is frequently the seat of pyogenic infection and of traumatic or trade bursitis, the latter being known as "miner's" or "student's elbow." [Illustration: FIG.
When there is hyperostosis and sclerosis, the shaft appears denser and broader than normal, and the contour is uneven or wavy. When there is a central gumma, the shadow is interrupted by a rounded clear area, like that of a chondroma or myeloma, but there is sclerosis round about. Diagnosis.
In soft central tumours, there is disappearance of bone shadow in the area of the tumour, while above and below or around this, the shadow is that of normal bone right up to the clear area. In many respects the X-ray appearances resemble those of myeloma.
A skiagram of a bone in which there is a chondroma shows a clear rounded area in the position of the tumour, which must be differentiated from similar clear areas due to other kinds of tumour, especially the myeloma; when it has undergone calcification or ossification, it gives a shadow as dark as bone. [Illustration: FIG.
Osteomalacia associated with New Growths in the Skeleton. When secondary cancer is widely distributed throughout the skeleton, it is associated with softening of the bones, as a result of which they readily bend or break, and after death are easily cut with a knife. In the disease known as multiple myeloma, the interior of the ribs, sternum, and bodies of the vertebræ is occupied by a reddish gelatinous pulp, the structure of which resembles sarcoma; the bones are reduced to a mere shell, and may break on the slightest pressure; the urine contains albumose, a substance resembling albumen but coagulating at a comparatively low temperature (140°
When resection is impracticable, a subcapsular enucleation is performed, followed by the insertion of radium. #Pulsating Hæmatoma# or #Aneurysm of Bone#. A limited number of these are innocent cavernous tumours dating from a congenital angioma. The majority would appear to be the result of changes in a sarcoma, endothelioma, or myeloma.
#Tumours of Tendon Sheaths.# Innocent tumours, such as lipoma, fibroma, and myxoma, are rare. Special mention should be made of the myeloma which is met with at the wrist or ankle as an elongated swelling of slow development, or over the phalanx of a finger as a small rounded swelling.
The myeloma is also to be diagnosed from chondroma, from sarcoma, and from osteomyelitis fibrosa cystica. [Illustration: FIG.
#Cysts of Bone.# With the exception of hydatid cysts, cysts in the interior of bone are the result of the liquefaction of solid tissue; this may be that of chondroma, myeloma, or sarcoma, but more commonly of the marrow in osteomyelitis fibrosa. Definition of terms Ankylosis.
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