A distinct variety of hip-joint disease in children and young persons / by Edmund Owen.

  • Owen, Edmund, 1847-1915.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: A distinct variety of hip-joint disease in children and young persons / by Edmund Owen. 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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    eventually be removeable witliout opening the joint, by tunnelling through the great trochanter. Interesting as these cases are, however, they have only a collateral bearing upon the subject of this pa^jer. Symptoms.—The two great features of the symptoms of this form of hip-joint disease are their acuteness and the suddenness of their appearance. In these respects the disease differs widely from tuberculous arthritis. For though each may come on after an illness or a hurt, it is the nature of the tuberculous disease to make its appearance slowly, and thus a faulty position of the thigh, a wasting of the muscles, and a limping gait may have existed for some while before the lesion is actually declared. Not so, however, with the septic disease : the child is attacked suddenly, and in the course of a few days the symptoms may have attained alarming intensity. In the case of tuberculous disease there is often a history of a long smouldering of equivocal symptoms before the flame breaks forth, but in the septic arthritis the blaze is almost instantaneous. The child looks extremely ill, and though its face may at times be flushed it may be extremely pale, and the expression anxious. There will probably be a history of sleeplessness, and most likely of delirium. As a rule, the temperature is high—up to 104° F, (40° C.), may be. But if, by chance, the first thermometric observation is taken when the disease has existed for some while, it may show nc elevation but actually a depression. The explanation of this is that the dose of toxic material elaborated by the growth of the micro- organisms may be so intense that the heat-producing centre, like every other area, is profoundly affected ; this general depression may end in a fatal collapse. As regards the local symptoms, the child dreads the least disturbance of the limb. Probably he cries out or screams when any attempt is made at examination, pointing to his hip and thigh when asked where the pain is. On his turning in bed, or on an attack of muscular