Of those admitted to Stannington, some were considered non-tuberculous and others had queries beside their tuberculosis diagnoses, therefore, differential diagnosis was required to ascertain the correct cause of the patient's ailments. The most common differential diagnosis given to patients at Stannington with queried TB of the bones and joints was Perthes' Disease of the hip, often mistaken as tuberculous-arthritis of the hip.

Perthes' Disease, a condition that usually affects children between the ages of 4 and 10, is a condition where the blood supply to the femoral head is temporarily lost. This causes the bone at the epiphysis of the femur to soften and breakdown, known as necrosis, and can often be identified in radiographic images due to the flattened appearance of the femoral head. Comparatively, tuberculous-arthritis of the hip can affect the femoral head and epiphyses but also the femoral neck and the acetabulum or socket joint of the hip and results in the gradual destruction of the hip joint beginning with a reduction in the joint space between the femoral head and the acetabulum and potentially ending with complete destruction of the joint.

Patient 84/42 was one such patient diagnosed with Non-TB Perthes' Disease of the left hip. She was admitted following complaints of pains in her left leg and development of a limp. No history of injury was reported and there was no family history of tuberculosis, although x-rays taken at Stockton and Thornaby Hospital had come with a provisional diagnosis of tuberculosis of the hip. On admission the patient had limitation of movement with muscle spasms in the left hip; some flexion was seen with shortening of ½" and wasting.

X-ray report notes from September 1940 read:

"Left hip flattening of head with fragmentation. Thickening upper end femur ? Perthes'"

This patient was discharged as improved in November 1940 and given a final diagnosis of non-TB Perthes' disease.

SEX: FEMALE

ADMISSION : 23rd Aug 1940

DISCHARGE : 29th Nov 1940

DIAGNOSIS: Non TB
Perthes' Disease

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