MULTIPLE CYSTIC TUBERCULOSIS OF THE BONES IN CHILDREN

Three factors probably predicate the rarity of cystic tuberculosis of the diaphysis of long bones. After an infection of the blood stream, localization of the tubercle bacillus in the bones elects the metaphyses owing to the anatomic situation of the end arteries; the caseous process of a tuberculous lesion of a bone is usually more rapid than fibrosis and may lead to abscess or sinus formation; generalized tuberculous infections in children are apt to precipitate a fatal outcome in a relatively short time.

The report of Jüngling¹ in 1920 of a tuberculous cystic condition of bones drew attention to an uncommon pathologic type which he termed osteitis tuberculosa multiplex cystica. In Jüngling's second report² 55 cases of this condition were reviewed, including 9 cases of his own. The characteristic features of the disease were listed as follows:

1. The onset was gradual with or without moderate pain in