Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


The initial local symptoms may be due to the presence of a focus in the
neighbouring bone, perhaps causing neuralgic pains in the joint, or
weakness, tiredness, stiffness, and inability to use the limb, these
symptoms improving with rest and being aggravated by exertion.


It is rarely possible by external examination to recognise deep-seated
osseous foci in the vicinity of joints; but if they are near the surface
in a superficial bone--such as the head of the tibia--there may be local
thickening of the periosteum, oedema, pain, and tenderness on pressure
and on percussion.

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