Licence: Public Domain Mark
Credit: Studies of old case-books / by Sir James Paget. Source: Wellcome Collection.
Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)
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![of tlie bed-sores, and the cavity of the right hii^-joint and the whole of the articular cartilage of the head of the femur had been destroyed by ulceration. Cases such as these, proving so grave injury of periosteum and bone after strains, may be enough to make it sure that strains of less severity, or in healthier persons, may produce many degrees of less, yet not unimportant, damage. An excellent example was in an elderly gentleman who came with a well- marked circumscribed periosteal swelling—a node it might have been called—on the inner border of his tibia, which had formed quickly after a severe night- cramp in the muscles of his calf. Much more common are the enlargements of the tubercle of the tibia which are often seen in young people much given to athletic games. They complain of aching pain at and about the ]3art, especially during and after active exercise, and the tubercle may be felt enlarged and is often too warm. The pain often continues, more or less, for many months, and there may be enlargement of the bursa under the ligamentum patellse, and the tubercle may remain too prominent; but common as are these cases, especially in our public schools, I have never known grave mischief ensue in any of them, and they get well of themselves. They may re- present one of the least degrees of periostitis due to strain; the increase of the prominence of the bone](https://iiif.wellcomecollection.org/image/b21290283_0024.jp2/full/800%2C/0/default.jpg)
