VII. INFECTIONS OF BONES AND JOINTS, EXCLUSIVE OF TUBERCULOSIS
—Owen,232 discussing acute hematogenous osteomyelitis, reemphasizes that it is a blood-borne pyogenic infection affecting principally the long bones of children and adults. The early diagnosis is made on the basis of sudden onset of fever, pain, localized deep tenderness and limitation of motion. The original infection is from some distant focus. The author stresses the fact that the earliest local signs are heat and increased tenderness on deep pressure with a normal roentgen picture. The infection spreads rapidly along the medullary cavity, starting in the metaphysis distal to the entrance of the nutrient artery. There is a plugging of part or all of the arterial tree with abscess formation, and as the infection spreads along the medullary canal and through the haversian canals it reaches the periosteum, which becomes undermined and stripped up.The author stresses the fact
PROGRESS IN ORTHOPEDIC SURGERY FOR 1941A REVIEW PREPARED BY AN EDITORIAL BOARD OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS. Arch Surg. 1942;45(5):792–862. doi:10.1001/archsurg.1942.01220050103009
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