. The diseases of children : medical and surgical. erent classes of cases come under observation : the one isa simple synovitis, usually traumatic, a lesion that occurs in the healthy andunhealthy alike, and is as amenable to treatment in the hip as other class is one composed of tuberculous patients ; from some injury,or even slight overstrain only of the part, the cancellous tissue of the bonehas its normal circulation slightly interfered with ; inflammation follows, andinflammation in a tuberculous subject is only too prone to follow the usualcourse of a tuberculous lesion, an
. The diseases of children : medical and surgical. erent classes of cases come under observation : the one isa simple synovitis, usually traumatic, a lesion that occurs in the healthy andunhealthy alike, and is as amenable to treatment in the hip as other class is one composed of tuberculous patients ; from some injury,or even slight overstrain only of the part, the cancellous tissue of the bonehas its normal circulation slightly interfered with ; inflammation follows, andinflammation in a tuberculous subject is only too prone to follow the usualcourse of a tuberculous lesion, and the special anatomical features of the hipjoint make it especially liable to serious and progressive disease. Necrosisof the pelvis or femur is common in the course of this disease ; thus in ourfirst hundred cases of excision there were seventeen instances in whichsequestra were found, either in or detached from the femur, and the aceta-bulum contained sequestra in twenty-two cases. The naked-eye characters of aare the following : The cartilage. Fig. 156.—There is disease onboth sides of the epiphysialline. On the under surface ofthe neck is the rough depres-sion caused by pressure againstthe rim of the was pathological dis-location. A section has beenmade through the upper endof the femur. typical specimen from hip disease in an advanced stageis all gone or hanging in tags or worm-eaten plates, orit may be merely loosened and thinned with a layer ofgranulations underlying it (fig. 156) ; the synovial mem-brane is red and vascular, somewhat thickened, but rarelyto anything like the degree already described in the caseof the knee joint. The bone, as seen in section, variessomewhat, but certain characters are very the whole upper epiphysis is detached andforms a hard, loose, marble-like sequestrum ; in a largernumber the upper epiphysis is destroyed to a greater orless extent : sometimes only a small part of it is actuallygone, but in all i
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Keywords: ., bookauthorwrightgageorgearthurb, bookcentury1900, bookdecade1900
