Licence: Public Domain Mark
Credit: Intra-uterine rickets / by J.W. Ballantyne. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![concavity of the scapula. The lower margins of the middle ribs were very thin, and were distinctly notched. The anterior ends of the two upper ribs on each side were directed upwards. In the case of the other ribs they were directed downwards. The inter- costal spaces were practically non-existent. The Long Bones of the Limbs.—The long bones had this peculi- arity in common, that whilst their ends were enormously large, the intervening shaft was small, short, straight, and nearly quite cylindrical. In the case of the femur there was a trace of the linea aspera, but in the case of the other long bones the shafts were quite smooth. The ends of the long bones were composed principally of cartilage greatly hypertrophied, and of softer con- sistence than is normal in the new-born infant; but at the line where the cartilage stopped and the bone began there was also a great thickening of the bone, so that the large ends of the bones were partly osseous, although principally cartilaginous. There was immobility of the joints and a certain amount of dislocation, especially in the case of the hip, shoulder, and ankle, and both the immobility and dislocation were apparently due to the enormous size of the opposing cartilaginous surfaces. Some of the characters of the individual long bones may be given here. The shaft of the humerus was straight, cylindrical, and short. The two extremities were greatly enlarged. The upper was somewhat round in form; the lower was broader transversely than antero-posteriorly. There were no ossific centres in the epiphyses. Taking the length of the humerus in the normal infant as 6 ctms., it was seen that in this case the bone was shorter than normal. The left humerus measured 4 ctms. in length, the right 3-9 ctms. The upper end of each humerus had a circumference of 7 ctms., whilst the circum- ference of the shaft was only 21 ctms. The radius and ulna were of equal length, each measuring 3'2 ctms., but the radius extended beyond the ulna below, and the ulna passed beyond the radius at the elbow-joint above. The interosseous space was 6 mm. in width. The lower end of the ulna had a marked concavity in- wards. The lower end of the radius had a circumference of 3 4: ctms.; the upper end had one of 2*6 ctms., whilst the shaft mea- sured only ]-3 ctms, in circumference. The upper end of the ulna had a circumference of 3 6 ctms., the lower end one of 3*3 ctms., whilst the shaft had one of only 1-4 ctms. The femur on both sides had a slight concavity inwards of its shaft. There was a distinct projection on the inner surface of the upper end corresponding in position to the trochanter minor, but the trochanter major was lost in the general caitilaginous mass. The head of the femur was no larger than a pea, but was ossified. The femur measured 4'5 ctms. in lengtli, the circumference at the upper end was 72 ctms., at the lower end 80 ctms., and at the middle of the shaft 21 ctms. TLe tibia was SS ctms. iu length, and its shaft had a circumference of 21 ctms. The shaft was thicker](https://iiif.wellcomecollection.org/image/b21915611_0012.jp2/full/800%2C/0/default.jpg)
