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The Journal of Bone & Joint Surgery British Volume
Vol. 36-B, Issue 4 | Pages 528 - 529
1 Nov 1954
Sissons HA


The Journal of Bone & Joint Surgery British Volume
Vol. 38-B, Issue 1 | Pages 418 - 433
1 Feb 1956
Sissons HA

1. The bone changes in four autopsied cases of Cushing's syndrome are described. The changes take the form of osteoporosis, which is most marked in the spine and the ribs.

2. The osteoporosis results from impaired osteoblastic bone formation in the presence of a normal degree of osteoclastic bone resorption.

3. Histological abnormalities of fracture callus in Cushing's syndrome indicate interference with the proliferation of osteoblasts and cartilage cells and with the formation of new tissue by these cells.

4. The bone changes in Cushing's syndrome are comparable with those produced in experimental animals by the administration of A.C.T.H. or cortisone.




The Journal of Bone & Joint Surgery British Volume
Vol. 34-B, Issue 2 | Pages 275 - 290
1 May 1952
Sissons HA

Amputation or post-mortem specimens from eight cases of joint tuberculosis, with immobilisation changes in bone, have been studied by fine-detail slab radiographs and subsequent histological examination. The findings in three of these cases are presented in detail.

The immobilisation changes take the form of a true osteoporosis, which is strikingly focal in nature. In the adult the sites of most marked involvement include the subcortical bone adjacent to articular surfaces and the bone in the neighbourhood of the obliterated epiphysial plates.

Areas of permanent change in bone structure may result, although commencing "repair" is seen in the form of newly developed bone trabeculae in the osteoporotic areas.

In one case, where immobilisation occurred at an early age, changes in the growing epiphysial plates were produced in addition to osteoporosis. This is correlated with the known susceptibility of growing epiphysial cartilage to a wide variety of damaging agents.

Radiologically, it is important to discriminate between these immobilisation changes and the bone destruction which might be produced by extension of the tuberculous lesion itself.