Hip disease in childhood : with special reference to its treatment by excision / by G. A. Wright.

  • Wright, G. A. (George Arthur), 1851-
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Hip disease in childhood : with special reference to its treatment by excision / by G. A. Wright. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    case of ulceration of cartilage:—A girl of seven, with hip disease and a sinus. The acetabular cartilage was entirely gone, and most of that on the head of the femur. Pus and granulations were found in the joint, and there was partial dislocation. The other (left) hip joint also contained pus and had ulceration of cartilage. The bones of the right hip were darker than normal and superficially- carious, those of the left healthy. The girl died of erysi- pelas. [Was not the affection of the left hip pyaemic, and was not the right a case of primary osteomyelitis, with secondary destruction of cartilage ?] Finally, he sums up his views by saying that a large proportion of diseased hips are cases of ulcerated cartilage, and it is the disease which forms the great majority of those cases of caries of the hip joint which occur in adult persons, whereas in children the hip joint is principally affected by the scrofulous disease affecting the cancellous structure of the bones. Key* as is well known, originated the classical belief that the disease begins in the ligamentum teres; this Brodie did not think correct, while Key further considered that ulceration of cartilage was always the result of overgrowth of synovial fringes. Bryant considers that hip disease is pathologically identical with other joint diseases; that it is not specially strumous; that it is local; that it is rare to find strumous or tubercular matter in the hip joint, and that as in other joints the disease may be primarily synovial or an articular ostitis. He thinks nine-tenths of the cases in early life are ostitis, those in adults commonly synovial. He points out that a hyperaemia of the articular extremity is followed by condensation of bone, and then by suppuration or necrosis, i.e., articular ostitis, and he also lays stress on the fact that the disease may begin in the epiphysial cartilage. * Med. Chir. Trans., vol. xvii.