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The presence of such stones in the kidney is very often inferential, and it will be a great boon, both to the surgeon and the patient, if we shall be able to demonstrate positively their presence by skiagraphy.
A careful consideration of the position in which the swelling first appeared, of the direction in which it has progressed, of its pressure effects, and of the condition of the pulses beyond, may help in distinguishing between aortic, innominate, carotid, and subclavian aneurysms. Skiagraphy is also of assistance in recognising the vessel involved.
To differentiate by manipulation between muscular fixation and ankylosis, it may be necessary to anæsthetise the patient. The nature and extent of ankylosis may be learned by skiagraphy; in osseous ankylosis the shadow of the two bones is a continuous one.
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