At first there is complaint of headache and an associated nasal discharge. At times the nasal passages may be obstructed by the developing growth, which however usually projects externally on both sides of the root of the nose just below the inner angle of the eyes. Breathing through the nose is not as a rule interfered with.
The bony exostoses develop in a downward and outward direction. The shape is generally oval. The disease commences in childhood and the bony outgrowths slowly increase in size so that by adult life they attain the size of a walnut. The overlying skin is normal and not attached to the bony tumor. As the tumors grow they tend to interfere with the vision of the patient. This is purely from obstructing the lines of vision as the growth does not usually invade the orbits. The treatment is entirely surgical and consists in chiselling away the bony outgrowth.
Juxta-articular Nodules
General Considerations
These nodular masses were first noted by Macgregor from cases in New Guinea but since then have been described from various parts of the tropical world.
These tumor masses were given the name juxta-articular nodules by Jeanselme, who studied the affection in natives of Siam. It may be stated that at present we know nothing definite as to etiology although several authors have reported fungi as the cause. This fungus has been stated to be a species of Nocardia. Some of the cases which have been reported would seem to be late manifestations of yaws.
Symptomatology and Treatment
These tumor masses vary in size up to that of a golf ball and are very hard in consistence. The skin over them is at first freely movable, but later on may become attached. They are located subcutaneously, especially about the external surfaces of the extremities and particularly in relation to the joints. They are not sensitive and rarely or never suppurate. The course is most chronic and but rarely do they become absorbed.
