Tuberculosis, like syphilis, taxes the alertness of the clinician by its tendency to occur in an insidious manner and irregularly in many localities in the human body. Every irregular feature of a case without manifest and striking symptoms must be diligently inquired into. The modern slogan of early diagnosis and early treatment should not be allowed to lose its force through the common failure which later requires radical and destructive as well as incapacitating measures in order to accomplish only partial rehabilitation. The roentgenogram—a shadowgraph—offers multiple opportunities for both brilliant diagnosis and conspicuous errors and oversights, especially in cases with manifest pathologic changes due to a general disease of long duration, such as tuberculosis or syphilis. The change in the chest, of both the bony and the soft tissues, wrought by tuberculosis is too well known to require review, and the heart is not an exception to the influence exerted
DUBROW JL. CHANGES IN THE ROENTGEN-RAY CARDIAC SHADOW: RESULTING FROM TUBERCULOSIS OF THE VERTEBRAE. JAMA. 1927;88(10):696–699. doi:10.1001/jama.1927.02680360008003
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