TUBERCULOSIS OF THE GREAT TROCHANTER
TUBERCULOSIS OF THE GREAT TROCHANTER
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DOI：
10.1136/bmj.2.4525.492
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发表时间：
1947-01-01
影响因子：
--
通讯作者：
MCMURRAY, B
中科院分区：
文献类型：
--
作者：
MCMURRAY, B
Discussion The congenital deformities. of her limbs are those of amyoplasia congenita. Apart from headaches, which'she has had as long as she can remember, the other main features of her condition pointto a pituitary or a pituitary-hypothalamic disturbance startingat the age of 19. These features are a large fat ruddy face, hirsuties, a buffalo distribution of fat, greasy skin, acne'and boils, a history of irregular menstruation, insulin-resistant diabetes (detected at the age of 52), hypertension, and a haemoglobin of 116%. The combination is suggestive of Cushing's syndrome but lacks some of its important features. The lateral radiographs of the skull establish the diagnosis of hyperostosis frontalis interna; in a few cases of this condition calcification has been seen, as in this patient, in the sella turcica. It is now generally accepted that this cranial dysplasia is a manifestation of pituitary dysfunction (Knies and Le Fever, 1941). In the description and classification of a large series of pituitary cranial dysplasias by Mortimer, Levene, and Rowe (1937) there are references to hyperostosis frontalis interna, though they do not use the term themselves. Both basophilic adenomatous masses and eosinophil adeno-mata have been found at necropsyin the pituitary glands of some of these cases. The low excretion of 17-ketosteroids is probably accounted for by the patient's age: Frazer et al.(1941) found that the daily output was low in the elderly. Henschen (1936) has suggested that in hyper-ostosis frontalis interna a hereditary influence determines the frontal localization of the bony changes, and it may be that there is in this case a common genetic factor responsible for both the limb deformities and the cranial dysplasia.
