Same as [Fig. 369], seen from below.
Acromegaly and Leontiasis
have been considered on [pages 437] and [438].
Acute Osteomyelitis.
—Acute osteomyelitis is due to essentially the same causes as those just discussed. In this case it is especially in the diploë that the principal ravages occur. Unless promptly recognized and relieved by surgical measures this is likely to lead to sepsis of the pyemic type and at a relatively early period, the venous arrangement of the diploë favoring such type of disease.
Necrosis of the Skull.
—Necrosis of the skull is ordinarily the result, directly or indirectly, of injury, in which case it is usually of the acute form, a fragment, which has been too much separated from its surroundings to live, giving evidence of early and easily recognizable death. This necrosis is mainly confined to the external table. Necrosis of slow origin is due either to tuberculosis or syphilis, perhaps more often to the latter. Under a cold abscess of the scalp or subperiosteal abscess will often be found a small area of dead external table which needs complete removal. Necrosis has also been observed to follow severe burns of the scalp. It is usually combined with caries of adjoining bone. The caries produced by syphilis is illustrated in [Fig. 371].
Fig. 371
