|
Patient 174/1946
This girl had previously spent 10 months in Stannington between 1941 and 1942 for tuberculosis of the rib stage I. She was readmitted in 1944 when a discharging sinus opened over her old scar, in the lower right side of the chest. In June 1945, during treatment for this old tuberculous scar, a second abscess formed over the which was aspirated and then x-rayed to reveal that the 12th dorsal vertebra was diseased.
Further deterioration followed and by December 1945, the abscess on the spine was being aspirated regularly, the result of which was a greenish pus and the corresponding x-ray report states that: "T12 def[initely] diseased, joint space between T11 & T12 much narrowed. T11 shows ill-defined outlines & decalcification."
Clinical examinations revealed no change to this patient but in March 1946, a curvature to the right is noted in the lumbar region of the spine, described as a scoliosis deformity - a lateral curvature of the spine. This is confirmed by x-rays with the report reading: "X-ray shows more scoliosis in the lumbar region curved to the Rt [right] - the lat[eral] view is not properly centred on the diagnosed part, but the appearance suggests quiescence."
With the disease in the spine in quiescence and demonstrating only a small kyphosis and scoliosis deformity this girl was put forward to be fitted for a spinal brace. As the year progressed further improvement was seen in the spine with x-ray reports from September 1946 reading: "The outlines of T10, 11 &12 are now clearly defined and fusion is proceeding and may be complete"
She is allowed to get out of bed in her brace from March 1947. The lesions in her spine were considered to be healed showing minimal deformity. She maintained residence in Stannington for a further year mainly as a result of: "Her brace, while of the right type, is now completely inadequate." Followed by comments: "It is impossible to compare x-rays. Could we have further views so centred that the intervertebral spaces are clearly demonstrated."
The brace was sent away to be refitted and upon return in October 1947 was considered satisfactory, but came with instructions that future lateral x-rays were to be taken on the left side. A change in x-ray technique was thought to be the reason behind previous x-rays being incomparable.
Report on discharge: "Clinical Record: General condition good. Temp[erature] normal & settled. Spinal lesion has healed with minimal deformity. X-ray Report: The lesion in D11 & 12 has healed with little deformity. Some of the intervertebral space is preserved & the bone texture normal. There is some erosion of the lower part of the vertebral body of D12. Recommendations as to subsequent treatment: Continue wearing spinal brace & return to Stannington for review in 2 months."
Click Images to Enlarge
|
