Excision of the scapula for progressive chronic interstitial myositis associated with obliterating endarteritis / by W. Barton Hopkins.

  • Hopkins, William Barton, 1853-
Date:
[1903]
Catalogue details

Licence: In copyright

Credit: Excision of the scapula for progressive chronic interstitial myositis associated with obliterating endarteritis / by W. Barton Hopkins. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    suppuration for a short time, when the wound closed permanently. An examination of the growth subsequently made proved that it was not one of sarcoma, but of progressive chronic interstitial myositis associated with obliterating endarteritis. Sections through the muscles attached to the scapula show the following condition reported from the Ayer Laboratory: The muscle-fibres in some sections are separated by a large amount of fat. Between the fat, the muscle-cells lie either in single narrow bundles with proliferation of nuclei and irregular ill-defined striations, or in small masses composed of several such muscle-bundles. In other sections areas of muscle-fibres have undergone complete degeneration, only here and there the nucleus retaining the stain. Between these areas the muscle-bundles are seen, some of them partially degenerated, others small, without striations and showing proliferation of the nuclei. Many of the fibres are broken and curled. In cross-section they bear a close resemblance to epithelioid cells with ingested nuclei. These areas of degenerating muscle are infiltrated with small round cells, epi- thelioid cells, and a few polymorphonuclear leucocytes. About the vessels are masses of small round cells with deeply staining nuclei. Capillaries are numerous in all these areas. In other sections the complete degeneration of the muscle is not so exten- sive, and here the masses of partially degenerating muscle com- prise the greater portion of the section. In all the vessels a very marked endarteritis is present, which becomes obliterative in the smaller vessels and almost closes the larger ones. The functional recovery of the upper extremity eight months after the operation was remarkable. The child could push and pull with the arm with considerable force. His general condition was satisfactory, and there was no sign of recurrence of the disease. Myositis or inflammation of the voluntary muscles usually occurs as an acute or subacute affection, and is probably dependent on some unknown infectious agent. The cases reported are few in number, and usually, unlike the one described above, have the entire muscular system affected. One of the best papers in recent years concerning the subject is that by Janowsky and Wyssoko- wicz (Deutsche Archiv fiir klinische Medicin, 1901, lxxi, 493), who, in connection with a case of dermatomyositis, discuss the literature and symptomatology of this peculiar affection. They