A treatise on orthopaedic surgery / by Royal Whitman.

  • Royal Whitman
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on orthopaedic surgery / by Royal Whitman. Source: Wellcome Collection.

    65/884 page 65
    The Roentgen Ray Photography as a Means of Diagnosis. ‘The Roentgen ray is of comparatively little importance from the diag- nostic standpoint, but it may be of value as a means of determining the exact extent of the disease. If the negative is well defined, the diseased vertebrae are seen to be irregular in outline, or they may be lost in a peculiar blur. By counting from above and below the exact extent of the disease may be made out, but infer- ences as to its character and quality must be made from the rational and physical signs (Fig. 34). The Record of the Case. The history and the results of the examination of the patient should be recorded somewhat in the following order : 1. The family and the personal history. 2. The history of the disease, with especial reference to its mode of onset, its probable duration, to the noticeable symptoms, and to previous treatment. FIGs 27. Nov. 2.1900 Tracings of the spine illustrating the recession of deformity. 3. The physical examination. This should include the general condition of the patient, the height and weight, the attitude, the character of the disease, whether progressive, as indicated by muscular spasm and pain on motion, or quiescent, the presence of abscess or paralysis as a complication, and, finally, the position and extent of the disease. This is best shown by a tracing, made by means of a strip of lead or pure tin, of such thickness that it may be readily moulded on the spine and yet hold its shape when removed (Fig. 27). The tracing should be of the entire spine, made while the patient lies extended in the prone position, and the exact location of the most prominent spinous processes should be marked upon it. In determining the position of the disease it is well to count the spinous processes from below upward, beginning with that of the fourth lumbar vertebra, which les on a line drawn between the highest points of the iliac crests. There are other landmarks 5
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