File:Syphilis - a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment (1921) (14586387639).jpg

Identifier: syphilistreatise00haze (find matches)
Title: Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment
Year: 1921 (1920s)
Authors: Hazen, H. H. (Henry Honeyman), b. 1879
Subjects: Syphilis Syphilis
Publisher: St. Louis : C.V. Mosby Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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periosteal thickening without. The lesionmay be complicated by necrosis, due to the obliteration of theblood vessels (osteolysis), but where necrosis has not occurred,the new formation of bone takes place. This combination of ero-sion and new bone formation is fairly characteristic of syphilis. Powers^^ says that ostitis must be differentiated from mye-loma ; in the latter condition the growth is uniform, the bonegradually becomes expanded, and there is evidence of interfer-ence with the circulation, that is, the cutaneous veins are en- DIAGNOSIS 515 gorged and there is edema below the tumor. Early cases aredifficult to differentiate by x-ray examination, but late myelomatashow absorption of bone in and around the growth without anythickening in the periosteum which is so characteristic of syph-ilis. Osteomyelitis is a condition in which the marrow is primarilyattacked and the trabeculae and cortex are at first but slightlyinvaded. The process may spread extensively in the marrow be-
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Fig. 144.—This illustration portrays the syphilis of the bones of the hands and fingers ina young child suffering from congenital syphilis. fore the cortex is involved. Adami says that it is rare in thelong bones, to which statement we take exception, but that it isoccasionally met with in the phalanges and in the diploe of thecranial bones. Powers believes that osteomyelitis, strictly speak-ing, includes every form of osseous infiamniation from a simpleperiostitis to the result of the most acute infection Avith pyogenicmicroorganisms. Fitzwilliams^- agrees with this and thinks thatthe whole thickness of the bone is attacked and replaced more orless completely with gummous tissue, which may eventually de- 516 SYPHILIS stroy the continuity of the structure without necessarily dis-charging through the skin. The radiogram of a pure osteomyeli-tis is not characteristic in syphilis and will not serve to establisha diagnosis of that disease. It will show rarefaction or de-struction of the

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