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September 2, 1939

Behandlung der Knochen- und Gelenktuberkulose nach den Erfahrungen von Hohenlychen vom November 1933 bis 1938

JAMA. 1939;113(10):967. doi:10.1001/jama.1939.02800350077031

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The authors present a critical review of 497 cases treated between November 1933 and November 1938. The rate of sedimentation was found to be a useful indicator of the activity of the process and was taken every four weeks. A low lymphocyte count with absence of eosinophils in the presence of a leukocytosis was considered an unfavorable sign. The Pirquet reaction was used in children but not in adults. Roentgenograms were of little use until after three months of the onset of symptoms. Biopsy and guinea pig inoculation were used in doubtful cases. The importance of general treatment and exposure to sun is stressed. Immobilization in generous casts is advocated, double hip spicas for knees and posterior shells for spines. The healing of synovial tuberculosis with good motion is reported. Deformities are corrected with stretching and casts or by osteotomy. Pott's disease is treated by recumbency in plaster until bony

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