Physical diagnosis (1912) (14773282375)

Identifier: physicaldiagnosi12cabo (find matches)

Title: Physical diagnosis

Year: 1912 (1910s)

Authors: Cabot, Richard C. (Richard Clarke), 1868-1939

Subjects: Diagnosis Chest Diagnosis

Publisher: New York : William Wood and Company

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

Text Appearing Before Image:

Fig. 235.—Syphilitic Periostitis (Salve Shins). usually leave a white scar; they may occur in the same situation,but are more common above the knee or on the calf. 3. Syphilitic periostitis is common on the shaft of the tibia, andgives rise to pain (worse at night) with tenderness and some swelling.Later bony nodes are sometimes formed, similar to those alreadypictured on the frontal bone. In doubtful cases of syphilis in otherparts of the body we may sometimes secure convincing evidence byradiography of the tibiae. Periosteal thickening, not otherwise THE LEGS AND FEET 431 recognizable, may be thus brought to light and may help our diagnosisof a cardiac arthritis or hepatic lesion. 4. Osteomyelitis (acute septic or chronic tuberculous) often startson the head of the tibia, with intense pain, tenderness, fever, andleucocytosis (if acute or septic); there results a general septicaemia ora local sinus leading to dead bone.

Text Appearing After Image:

Fig. 236.—Angioneurotic oedema of legs. 5. Sarcoma not infrequently attacks the upper end of the tibia orfibula, producing lesions similar to those described in the femur. 6. (Edema of the legs1 is oftenest due to: (a) Uncompensated heart lesions, primary or secondary fromlung disease. (6) Nephritis. (c) Cirrhotic Liver. (d) Anaemia. 1 It is notable that oedema is usually greatest in the front of the leg and in the back ofthe thigh. 432 PHYSICAL DIAGNOSIS (e) Neuritis (alcoholic, beri-beri, etc.). (/) Varicose veins. (g) Obesity, flat-foot, and other causes of deficient local circu-lation. In some cases no cause can be found (angioneurotic oedema,essential and hereditary oedema). Diagnosis of the cause of

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1912

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