United States or Colombia ? Vote for the TOP Country of the Week !
They are considered in greater detail in the chapter dealing with tumours of bone. Minute nodules of cartilage sometimes form in the synovial membrane of joints and lining of tendon sheaths and bursæ: they tend to become detached from the membrane and constitute loose bodies; they also undergo a variable amount of calcification and ossification, so as to be visible in skiagrams.
The contents may be clear yellow serum or watery pus; sometimes a small spicule of bone is discharged. Valuable information, both for diagnosis and treatment, is afforded by skiagrams.
A rarer variety is the ossifying chondro-sarcoma, which undergoes ossification to such an extent as to be visible in skiagrams. In primary sarcoma the treatment consists in removing the muscle. In the limbs, the function of the muscle that is removed may be retained by transplanting an adjacent muscle in its place. Hydatid cysts of muscle resemble those developing in other tissues.
The lesion presents, on a small scale, all the anatomical changes that have been described as occurring in the medulla of the tibia or ulna, and they are easily followed in skiagrams. A periosteal type of dactylitis is also met with. The clinical features are those of a spindle-shaped swelling of a finger or toe, indolent, painless, and interfering but little with the function of the digit.
In both diseases there is a tendency to pathological fracture. It is difficult also in the absence of skiagrams to differentiate the condition from syphilitic and from tuberculous disease. If the diagnosis is not established after examination with the X-rays, an exploratory incision should be made; if dead bone is found, it is removed.
In the syphilitic lesion, skiagrams usually show a more abundant formation of new bone, but in many cases the doubt is only cleared up by observing the results of the tuberculin test or the effects of anti-syphilitic treatment. Sarcoma of a phalanx or metacarpal bone may closely resemble a dactylitis both clinically and in skiagrams, but it is rare. Treatment.
When attended with suppuration, the condition has been mistaken for disease of the jaw. Fibrous odontomas have been mistaken for sarcoma, and portions of the maxilla removed unnecessarily. Any circumscribed tumour of the jaw, particularly when met with in a young adult, should suggest the possibility of an odontoma. Skiagrams often give useful information both for diagnosis and for treatment.
These changes are well brought out in skiagrams; instead of the well-defined narrow line which represents the epiphysial cartilage, there is an ill-defined, blurred zone of considerable depth. In the shafts of the long bones, owing to the excessive absorption of bone, the cortex becomes porous, the spongy bone is rarefied, and the bones readily bend or break under mechanical influences.
Skiagrams of the hands and feet show a deposit of new bone along the shafts of the phalanges. New growths which originate in the skeleton are spoken of as primary tumours; those which invade the bones, either by metastasis from other parts of the body or by spread from adjacent tissues, as secondary.
It is best illustrated in arthritis deformans of the hip in which new bone formed round the rim of the acetabulum mechanically arrests the excursions of the head of the femur. The new bone, which limits the movements, is readily demonstrated in skiagrams; it may be removed by operative means.
Word Of The Day