This patient was admitted to Stannington from the RVI, Newcastle. He had a history of whooping cough which developed into weight loss and a dry cough. A cold abscess had been present on his left clavicle which healed and three months later a second abscess appeared on the top of the right foot which subsequently broke down and began to discharge. This was followed by the formation of an abscess on the left elbow which ulcerated and a swelling over the mid-lumbar spine; it was only at this stage he was admitted to hospital. A letter concerning his transfer to Stannington outlined the condition of his elbow on admission to the RVI: "a considerable swelling of the left elbow with a granulating surface and discharging sinus over the olecranon..."

X-ray reports noted TB osteitis of the upper end of the left ulna and periosteal reaction in lower third of the left humerus.

Whilst in hospital the patient's sinuses became secondarily infected with Staphylococcus and as a result he was put on a course of systematic penicillin. The secondary Staph infection was treated for several months with a combination of locally injected, systematic and cream based penicillin. In March 1946 two distinctive abscesses formed, one on the anterior and one on the postero-medial aspect of the elbow joint. A letter sent to Stannington requesting a bed for this patient noted that this he did not require any specialist treatment.

On admission to Stannington it was noted the patient's general condition did not deteriorate any further in fact the elbow began to make some improvements, however, the secondary infection continued to be treated. The x-ray reports for April 1946 and October 1946, respectively, read: "30/4/1946 - Olecranon compl[etely] destroyed. Soft tissues show considerable thickening & swelling. 3/10/1946 - Elbow: there is a little regeneration of the upp[er] end of the ulna, on the other hand the lower end of the humerus & the upp[er] end of the radius are less clearly defined & there is more rarefaction."

By January 1947, the left elbow had less soft tissue swelling and the sinuses and ulcers appeared to be filling in. Better definition could be seen in the patient's radiographs with calcification in the articular ends of the humerus, ulna and radius. Throughout the rest of his stay in Stannington this patient continued to show improvement in his elbow, but continued to be treated for tuberculous infection in his foot and lumbar spine. Upon discharge he had achieved partial ankylosing and had a small range of movement.

This patient returned as an out-patient in 1950 where x-rays showed: "There is considerable distortion of the articular surfaces in the left elbow. There appears to be complete medial luxation of the joint; nevertheless, the epiphyses at the lower end of the humerus and the upper end of the radius, and possibly the upper end of the ulna, can be identified. There is no evidence of activity."

SEX: MALE

ADMISSION : 28th April 1946
DISCHARGE : 28th May 1948
DIAGNOSIS: TB Left Elbow; Rt Foot - 1st Metatarsal; 4th Lumbar Vertebrae - spinous process