A Benign Form of Osteomyelitis of the Spine

Abstract

financial resources. Into the latter category most of the Southern states fall. Because, also, of the fact that the county forms the political unit of government in the South to a greater extent than prevails in many Eastern states where the township dominates the politi¬ cal picture, organization for many types of health service has been simplified and expedited. In Alabama, for example, where up to now 80 per cent of the coun¬ ties have been provided with all time health service, it is felt that the possibilities are promising of further expanding and superimposing on an already existing county setup a simple and workable plan of local tuber¬ culosis control. Up to the present time, so far as my knowledge goes, no one has succeeded in clearly defining the salient points that should be incorporated into such a plan, nor has there been pointed out the superfluous things that need not be so incorporated. Some two years ago and because of the many shapeless gropings in which we were floundering, Alabama's health depart¬ ment set for itself this rather pretentious task. A tentative plan, embracing the cardinal points enumer¬ ated, was submitted to the International Health Board of the Rockefeller Foundation and an appeal made for financial aid in its prosecution. After an exhaustive study of every detail, including the proposed field of operation and the personnel to be employed, the founda¬ tion generously consented to make such a study finan¬ cially possible. This study has been in progress now for one year.In essence, its purposes are : 1. To determine the incidence of all manifestations of tuberculous infection under conditions that exist in a rural community and their potential significance in relation to clinically manifest tuberculosis.2. To ascertain the principal channels of spread in a rural community and the factors that modify its transmission.3. On the basis of the information thus obtained, to devise practical preventive measures suitable to local conditions. The general plan of procedure will be as follows : 1. The family or household is the unit of study and all families in which there now exists, or where at some time a member has suffered with tuberculosis, will be the nucleus for the study of the disease.2. The search for new cases will be conducted on a countywide basis, all available means being used.3. A complete tuberculin survey will be undertaken to include (a) all school children, both white and col¬ ored; (b) adults and preschool children by precincts or beats; (c) municipal and industrial groups. This should serve to indicate the difference in the incidence of infection in town and rural areas. 4. In areas selected, on the result of tuberculin tests, an epidemiologie survey of the families within the areas will be made, with follow-up roentgen examination of selected positive reactors.5. The clinic is mobile and equipped with portable x-ray apparatus. Seven convenient points within the county, where electric current is accessible, have been selected as clinic centers. Provision is always ...

Spondylodiscitis in Childhood: Results of a Long-Term Study

“…5 Smith described 17 "benign" cases of spinal osteomyelitis in 1933. 6 In discitis, the inflammation is restricted to the disc, whereas in spondylodiscitis, both the disc and the adjacent bony structures are affected. 7,8 Because supply vessels persist for several years after birth, an isolated inflammation of the disc can occur in childhood.…”

Critique and Cavil

“…It is important to note that this disease may present a benign clinical picture, or simulate other conditions. 4 When blood cultures were negative, biopsy was not only a valuable aid to diagnosis but mandatory for accuracy, because x-ray findings were incon¬ clusive. Trocar biopsy provided a final diagnosis in 16 cases, and the culture and sensitivity determi¬ nation simultaneously obtained provided a basis for a rational selection of appropriate antibiotics in seven of these cases.…”