Osteo-arthropathy and its relationships : with abstracts of recorded cases, and a note by Dr. E. Legrain on cases observed in the Sahara : also a case of hyperplastic osteo-arthritis / by F.R. Walters.

  • Walters, F. Rufenacht (Frederick Rufenacht)
Date:
1897
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Licence: Public Domain Mark

Credit: Osteo-arthropathy and its relationships : with abstracts of recorded cases, and a note by Dr. E. Legrain on cases observed in the Sahara : also a case of hyperplastic osteo-arthritis / by F.R. Walters. 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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    least affected parts being tbe lower end of tlie femur and upper ends of tibia and fibula, radius and ulna. The peri- osteum is usually thickened, sometimes adherent, sometimes readily detached and highly vascular. In Freytag's case (No. 34) two layers were readily distinguishable in the thickened periosteum, the deeper one containing bony spicules or imperfect bone, while the older subjacent bone was unaltered. In Case 25 the affected surfaces were covered with soft, red or bluish-red, velvety or warty osteophytes, lamellar in texture, somewhat like the peri- osteal deposits in some syphilitic cases, while the subjacent bone was either normal or slightly thickened. The osteo- phytes varied in coarseness, and were sometimes disposed in fine parallel lines, sometimes forming large bony crests exaggerating natural markings, sometimes bossy or warty projections, while in the least affected parts the surface was finely porous. The nutrient foramina were unusually large. The subjacent cortex was thick and sclerosed, this change being especially noticeable in the spongy bone at the epi- physes. Another of Bamberger's cases (No. 23) merely showed regular thickening and sclerosis of the cortex and epiphysial spongy bone, and Bauzier's case (No. 22) was similar in this respect. Perhaps these represent a slight attack in a later stage. In Therese's case (No. 19), de- scribed by Lefebvre, the thickened periosteum covered a lamellated deposit of soft new bone in several layers, con- taining externally no Haversian canals, but a number of flattened channels at right angles to the surface; beneath this irregular bone spaces with medullary tissue containing abundant embryonic cells ; and more deeply still a layer of dense bone with enlarged Haversian canals, a similar layer being found next the medullary cavity. The marrow in the medullary cavity was fattily degenerated in the centre, em- bryonic in character further out. This probably represents a recent stage. It is noteworthy that whereas the terminal phalanges in Bamberger's case (No. 25) showed warty excrescences on both fingers and toes, those in Freytag's and Therese's cases (Nos. 34 and 19) showed no such projections, but were merely porous (Case 19). I omit the histology of Erb's