Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


The local manifestations are pain and tenderness in relation to one of
the long bones; the pain may be so severe as to prevent sleep and to
cause the child to cry out. Tenderness on pressure over the bone is the
most valuable diagnostic sign. At a later stage there is an ill-defined
swelling in the region of the ossifying junction, with oedema of the
overlying skin and dilatation of the superficial veins.


The swelling appears earlier and is more definite in superficial bones
such as the tibia, than in those more deeply placed such as the upper
end of the femur. It may be less evident to the eye than to the fingers,
and is best appreciated by gently stroking the bone from the middle of
its shaft towards the end. The maximum thickening and tenderness usually
correspond to the junction of the diaphysis with the epiphysis, and the
swelling tails off gradually along the shaft. As time goes on there is
redness of the skin, especially over a superficial bone, such as the
tibia, the swelling becomes softer, and gives evidence of fluctuation.
This stage may be reached at the end of twenty-four hours, or not for
some days.

PREVIOUS GROUP HOME SITE HOME NEXT
Part of the RabbitHoleResearch Project
Change Tag: ~~ 0 ~~