Identifier: diseasesofchildr00grah (find matches)
Title: Diseases of children
Year: 1916 (1910s)
Authors: Graham, Edwin Eldon, b. 1864
Subjects: Children Disease
Publisher: Philadelphia and New York, Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
uberculous and syphilitic forms the process,which is a rarefying osteomyelitis, begins in the centre of the bone, CRANIOTABES 521 resulting in an enlargement of the medullary canal, while at the sametime there is a proliferative periostitis, causing a fusiform enlargement.Suppuration and necrosis occur, and a finger or toe may be lost.An acute dactylitis, arising from streptococcic infection or trauma,presents the symptoms of acute osteomyelitis. Diagnosis.—Syphilitic dactylitis is more common than the tuber-culous form. It occurs most frequently during the first two years andusually involves several bones. The proximal phalanges are apt to beinvolved in syphilis, and there is not the tendency to affect the meta-carpals, seen in tuberculosis. There is rarely suppuration, and thesurrounding tissues are usually not involved if the type be syphilitic. In the tuberculous form metacarpals and phalanges are involved.There is tumefaction, due mostly to swelling of the soft tissues, and the
Text Appearing After Image:
Fig. 53.- -Syphilitic dactylitis involving all fingers and thumb of left handand thumb of right hand. part is tender. The tuberculous lesions are less apt to be multiple.The history of the case, the presence of concomitant symptom.s of eitherdisease, and the Wassermann and von Pirquet tests are additionalaids to diagnosis. Prognosis.—The underlying constitutional disease should be treatedat once. Locally the part should be put at rest and kept immobileby splints for months. Abscess formation and necrosis, if they occur,require surgical intervention. CRANIOTABES. Craniotabes is a condition characterized by the presence of softspots of thinning in the cranial bones. It may be due to several causes.Syphilis is found in over 50 per cent, of the cases. Rachitis is also 522 DISEASES OF THE BONES AND JOINTS present quite frequently, and the most marked cases are seen in chil-dren with both syphilis and rachitis. It may occur in hydrocephalusof the chronic type. In a certain percentage of t

Note About Images