Manifestations of yaws in Great Britain.

Abstract

Within the last year or two, 12 patients have been examined whose bones showed abnormalities all of a similar type (Figs. 1 and 2). These lesions can be described as: 1. Bosses of cancellous bone up to 5 cm diameter. The structure of these swellings was continuous with the normal bone shaft but thick cortical bone was lacking over the projection. 2. Diffuse expansion of part of the shaft of a long bone. The bone pattern was normal or somewhat coarse, there was no thick cortical bone. This condition was only a more extensive form of the one already described but involved both margins of the bone. 3. Patches of superficial but chronic periostitis. 4. Dense inactive periostitis causing thickening of the cortex and irregularity of its outline over a considerable length of bone shaft. 5. Patchy erosion of cortex and medulla with periostitis more or less active in appearance. Any one of these changes may occur by itself but in nearly all a number of lesions of different types were found in different bones. The bone most frequently affected was the tibia, but fibula, ulna, radius and femur were almost as commonly involved. The shaft was the part usually affected but there was no effect on any joint nearby. All the patients were coloured West Indians who had recently reached this country (most of them from Jamaica).