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OSTEITIS TUBERCULOSA MULTIPLEX CYSTICA (JÜNGLING) Report of a Case Involving the Larger Long Bones with Complete Proof of Its Tuberculous Etiology. A Review of the Literature
GUY S. VAN ALSTYNE; G. HOWARD GOWEN
The Journal of Bone & Joint Surgery.  1933; 15:193-205 
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Abstract

We feel justified, from the history and findings here presented, in placing this case under Jüngling's classification of osteitis tuberculosa multiplex cystica.

We have found no report in the literature of this disease occurring in the larger long bones.

Previous authors have based their claim for a tuberculous etiology on few positive findings or even on indirect evidence. We have been able to fully establish positive proof of its tuberculous nature by: (1) microscopic tubercles in the cyst wall and in a regional lymph gland; (2) tubercle bacilli in the cyst content; (3) microscopic tubercles in the tissues of a guinea pig six weeks after inoculation; (4) tubercle bacilli in the inoculated guinea pig's lymph nodes; with (5) a positive von Pirquet test, (6) marked chronicity from the start, and (7) a very possible preexisting pulmonary tuberculosis.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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