On disease of the hip-joint / by Lewis A. Sayre.

  • Lewis Sayre
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: On disease of the hip-joint / by Lewis A. Sayre. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Later in life, these trivial injuries attract attention and are immedi- ately cared for, which is the reason, I presume, that the disease is not more frequently found in adult life. The pathological changes that these causes produce are either Synovitis, from a rapid and excessive change in temperature; or violent wrenches or strains, tearing from its attachments the liga- mentum teres, thereby inducing necrosis of the head of the femur from rupture of the blood-vessel which supplies it; or concussions, falls, jumps, blows, will produce an extravasation of blood in the articular lamella, which sets up an inflammation, the cartilages soon die on account of their low vitality, become eroded and ne- crotic, interstitial absorption of the bones takes place, due to the constant pressure from muscular contraction, and, finally, exfolia- tion. But, no matter what the cause, or which of the tissues originally involved, they all, sooner or later,, become commingled and included in the general destruction. I don’t believe the dis- ease ever commences in the cartilage, as it is entirely without blood-vessels and nerves, and lives simply by imbibition. For convenience of description, we will divide the disease into three distinct stages,as each represents a different pathological con- dition of the parts involved, and as the symptoms also vary to a greater or less degree :— 1. The stage of irritation. 2. The stage of effusion. 3. The stage of rupture of the capsule, or perforation of the acetabulum. In the first stage, or stage of irritation, as it may be called, before effusion has occurred within the joint, the symptoms are not well pronounced, and it often requires a very careful investigation in order to diagnosticate the disease. Generally, the first thing noticed is that the child appears very slightly lame when he first gets out of bed in the morning, or when first he moves about after some hours of rest. This limping or halting gait is so slight as hardly to be