There is little to be found in the literature concerning spurs of the os calcis due directly to gonorrhea, though each textbook on orthopedic surgery touches on it lightly. The condition is painful to the patient, and is often placed under the erroneous diagnosis of arthritis.
Three patients have come under my observation suffering from this affection, giving histories of good health and no discomfort previous to an attack of gonorrhea. Other etiologic factors which must be thought of in connection with painful heels are flat foot, syphilis, achillobursitis, etc.
"Ossifying periostitis leads to the formation of bony excresences, exostoses or osteophytes. First there is a proliferation of the osteogenic layer of the periosteum, then partial ossification, and finally complete bone formation with firm attachment to the underlying bony structure. The osteogenesis is essentially the same, but the periosteal bone depositing cells are working in a tissue the seat of