File:American practice of surgery - a complete system of the science and art of surgery (1906) (14779310351).jpg

Identifier: americanpractice03brya (find matches)
Title: American practice of surgery : a complete system of the science and art of surgery
Year: 1906 (1900s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914 Buck, Albert H. (Albert Henry), 1842-1922
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Publisher: New York : W. Wood and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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laare apparently healthy, but the inner part of the epiphysis of the tibia has been destroyed and a largesequestrum is seen in that locality. The radiograph of the diseased knee (Fig. 1) may be comparedwith that of the sound side (Fig. 2). The patient was ten years of age and hail suffered from troublein the knee for a year before the r-ray picture was taken. There were marked enlargement of the jointand flexion deformity. The tumefaction had increased very much for a month before the skiagraphwas made, and an abscess had opened over the inner tuberosity of the tibia. There was marked in-filtration of the synovial membrane. At an operation performed upon the joint the accuracy of theconclusions arrived at from the study of the radiograph was confirmed. The .r-rav picture was reproduced by Dr. S. Cummings, of Toronto, under whose care the patientwas treated and to whom the author is indebted both for the photographs and for the history of thecase. AMERICAN PRACTICE OF SURGERY PLATE XXV
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RADIOGRAPHS ILLUSTRATING TUBERCULOUS DISEASE IN THEKNEE-JOINT IN A PATIENT 10 YEARS OF AGE TUBERCULOUS DISEASE OF BONES AND JOINTS. 651 the hip will enable one to exclude hip disease without much difficulty, but inyoung children it may be exceedingly difficult to differentiate. If the thighis flexed on the abdomen so as to relax the psoas muscle, then, in the absenceof hip disease, the movements at that joint are unrestricted. This is a veryuseful method of examination in these cases. When psoas abscess exists as a result of spinal disease, and when the abscessextends down below Pouparts ligament, we get, on the antero-internal aspectof the thigh, a fluctuating tumor which may be mistaken for an abscess hav-ing its origin in the hip. If such an abscess were the result of hip disease wewould expect indications of trouble in the hip of a marked character, with eleva-tion of the trochanter major and other evidences of destructive changes in thejoint. These, however, are absent in spinal

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