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dc.contributor.authorBrown, James Johnston Masonen
dc.date.accessioned2018-03-29T12:21:17Z
dc.date.available2018-03-29T12:21:17Z
dc.date.issued1935en
dc.identifier.urihttp://hdl.handle.net/1842/29446
dc.description.abstracten
dc.description.abstractIn the earliest days of medical science, diseases with the same symptomatology were regarded as having the same etiology. It is, however, a well known fact to -day that diseases with quite distinct etiologies may have the same symptoms; for example, locking of a joint may arise from a wide variety of causes both extra- and intra -articular . It was only through the final court of appeal of the post -mortem examination that the earliest workers were able to differentiate diseases with similar symptoms but with the increase in knowledge and with additional methods of examination - radiological, biochemical, bacteriological and in biopsy, which Moynihan has so aptly named "the pathology of the living" - we have additional criteria for the recognition and classification of disease.en
dc.description.abstractPrior to the general use of Roentgen rays in the examination of the bones and joints it was a commonplace that some cases of tuberculosis of the hip joint recovered rapidly with little subsequent disability and it was only with the aid of the X -rays that this apparent anomaly was explained by the recognition of the disease first described by Legg Calvé and Perthes.en
dc.description.abstractAdvances in our knowledge depend not only on the development of new methods of examination but are occasionally inaugurated quite by chance. In diseases which are seldom if ever fatal during their active stages, the progress of knowledge must of necessity be slow because of our inability to obtain pathological material and, although osteo-cartilaginous loose bodies in joints have been recognised since the time of Alexander Monro over two hundred years ago, it was not until 1928 that a complete specimen of the loose body lying in its bony bed was accidentally found in a patient who died of diabetes mellitus. This specimen was unfortunately complicated by the presence of a bone cyst - further reference will be made to its pathological features below. In tanuary 1934 a patient reported at the Surgical Out- Patient Department of the Royal Infirmary and was found to have a small lesion of osteochondritis dissecans in the internal condyle of the femur. At operation it was possible to remove the loose body and the bone forming its bed without damaging the knee joint. As far as I can ascertain this is the first complete uncomplicated lesion which has become available for pathological examination and I am deeply grateful to Mr D. Stewart Middleton for placing the specimen at my disposal.en
dc.description.abstractDuring my work as a clinical tutor in the Out - Patient Department I have been struck by the similarity of the X -ray appearances of some cases of Kbhler's disease of the second metatarsal head with the radiological changes in osteo- chondritis dissecans - an added incentive for a full investigation of the two conditions.en
dc.description.abstractTo the popular imagination a research worker is a solitary figure trying to find his way across uncharted seas on a voyage of discovery but this is not the case. The scientist must use the painstaking work and the experience of other workers as recorded in the various journals. He will be encouraged by his conversation with others and, better still, his theories will be criticised, giving him a different viewpoint. It is only, therefore, by collective work that progress is made and the individual worker merely adds another chapter to the book of knowledge This contribution may stand the test of time or may finally be disproved by the work of new workers in the same field, and it is with the utmost diffidence that I submit my theory of the causation of osteochondritis.en
dc.description.abstractAlthough a disease of comparatively recent discovery, a wealth of literature has grown up and a plethora of articles has been written. No disease in the whole of medicine or surgery has so many different names and their variety only serves to show our ignorance of the etiology. Perhaps the worst feature of the nomenclature is the tendency to name after the original describer the conditions in the various parts of the body and this has only served still further to complicate the terminology. It is not my intention to review the entire literature of more than seven hundred articles but, after a brief summary of the various factors previously considered of etiological significance, to try and justify a theory founded on pathological examination which would explain osteo -chondritis in any situation.en
dc.publisherThe University of Edinburghen
dc.relation.isreferencedbyen
dc.subjectAnnexe Thesis Digitisation Project 2018 Block 17en
dc.titleOsteochondritis dissecans: etiology and pathology, and its relation to Kohler's disease of the second metatarsalen
dc.title.alternativeOsteochondritis dissecans: etiology and pathology; its relation to Kohler's disease of the second metatarsal: submitted for the Syme Surgical Fellowship, 1935en
dc.typeThesis or Dissertationen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnamePrize Essayen


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