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CHAPTER 30
sores with underlying osteomyelitis. On the left side the ischial ramus is greatly destroyed
and has a moth-eaten appearance, the right ramus is in an early stage of osteomyelitis,
but both rami show ectopic bone formation as a result of the infection.
The great danger of developing osteomyelitis, following pressure sores of the trochan-
teric and, in particular, the ischial regions, cannot be stressed too much, having regard
to the neighbourhood of the hip joints. In fact, in several patients admitted to the
Centre, septic arthritis of the hip joints, with profound destruction of the acetabulum
and head of the femur, was found (Fig. 207). In other cases, the septic arthritis involved
the knee joints (Fig. 208). In cases with large sacral sores, the coccyx and part of the
sacrum were found to be completely disintegrated and the ischio-iliac joint obliterated.
Sores over the toes may also destroy joints (Fig. 209).
FIG. 209.
