Klein’s Lines

Other Known Aliases – Line of Klein

Definition – Virtual line drawn parallel from the femoral neck that should intersect the lateral upper edge of the femoral head

Clinical Significance – Used in the radiographical diagnosis of slipped capital femoral epiphysis and allows for early diagnosis and surgical management to prevent avascular necrosis as an adult. The sensitivity and specificity are the highest if modified by a ≥2mm difference in the epiphyseal width lateral to Klein’s line compared to the unaffected side.

History – Named after Armin Klein (1892-1954), who was an American orthopaedic surgeon and received his medical doctorate from Harvard Medical School in 1927. He completed his residency at Boston City Hospital and upon completion joined the faculty at Massachusetts General Hospital. It was here in 1952 that Klein and three colleagues published a case series on children with previously undiagnosed SCFE, but with positive findings using his technique. He would later go on to become Chief of Orthopaedic Surgery at the new Beth Israel Hospital in Boston and obtained teaching positions at Harvard Medical School and Tufts College Medical School.

References

1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
5. Up To Date. www.uptodate.com
6. KLEIN A, JOPLIN RJ, REIDY JA, HANELIN J. Slipped capital femoral epiphysis; early diagnosis and treatment facilitated by normal roentgenograms. The Journal of bone and joint surgery. American volume. 1952; 34-A(1):233-9. [pubmed]
7. https://journals.lww.com/jbjsjournal/Citation/1954/36040/ARMIN_KLEIN_1892_1954.29.aspx

Sjögren’s Syndrome

Other Known Aliases – Gougerot’s syndrome

Definition – chronic autoimmune inflammatory disease characterized by diminished lacrimal and salivary gland function

Clinical Significance – Patients affected by this disease have dry eyes, dry mouth, dry skin, and various other systemic abnormalities. The exact mechanism is unknown, but is believed to be a combination of genetics (HLA association) and environmental triggers (viral pathogens).

History – Named after Henrik Samuel Conrad Sjögren (1899-1986), who was a Swedish ophthalmologist who received his medical doctorate from the Karolinksa Institutet in 1922. He married a classmate of his (Maria Hellgren), who also happened to be the daughter of one of the most prominent ophthalmologists in Stockholm. He first encountered his future eponymous disease in 1925, and published a case report of five patients in 1930. He completed his doctoral thesis in 1993 on “Zur Kenntnis der keratoconjunctivitis sicca”, but unfortunately did not earn him the title of docent to pursue a career in academia. He did however enjoy a prolific career with numerous honorific appointments…..including docent at the University of Göteborg in 1961.

References

1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
5. Up To Date. www.uptodate.com
6. https://hekint.org/2018/09/11/henrik-sjogren-and-his-syndrome/
7. Sjögren H. Zur Kenntnis der keratoconjunctivitis sicca. Keratitis filiformis bei Hypofunktion der Tränendrüsen. Acta Ophthalmol. 1933;2:1–151
8. Murube J. Henrik Sjögren, 1899-1986. The ocular surface. 2010; 8(1):2-7. [pubmed]

Thompson’s Test

Other Known Aliases – Simmond’s Test

Definition – passive accessory movement test of the ankle to test for a ruptured achilles tendon

Clinical Significance – To perform, place the patient in a pron position or kneeling on the injured extremity’s knee without supporting the foot and ankle. The grasp the muscle belly of the gastrocnemius and observe for passive plantarflexion. A positive test results in inability to plantarflex and confirms a complete rupture of the achilles tendon.

History – Named after Theodore Thompson (1902-1986), an American orthopaedic surgeon who received his medical doctorate from Johns Hopkins University in 1928. Prior to enrolling at Hopkins, he was involved in a traumatic arm injury working at a steel mill where his arm went through a planer. Luckily, a local orthopaedic surgeon, knowing Thompson want to go into medicine, did not amputate and reconstructed his arm to regain full function. His career achievements include heading the amputation center at Walter Reed Hospital during World War II and becoming president of the American Academy of Orthopaedic Surgeons in 1954. He described his eponymous finding in 1962 in two separate articles….which was AFTER Franklin Adin Simmonds (1910-1983), a British orthopaedic surgeon, published the same findings in 1957. Thompson did however acknowledge and reference Simmonds in his 1962 paper. Depending on what side of the pond you trained on will determine how you learned the name of this test.

References

1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
5. Up To Date. www.uptodate.com
6. THOMPSON TC, DOHERTY JH. Spontaneous rupture of tendon of Achilles: a new clinical diagnostic test. The Journal of trauma. 1962; 2:126-9. [pubmed]
7. THOMPSON TC. A test for rupture of the tendo achillis. Acta orthopaedica Scandinavica. 1962; 32:461-5. [pubmed]
8. Simmonds FA. The diagnosis of the ruptured achilles tendon. The Practitioner. 1957;179(1069-1074):56-58 [article]
9. Physiopaedia. Thompson Test. https://www.physio-pedia.com/Thompson_Test

Lachman’s Test

Other Known Aliases – none

Definition – passive accessory movement test of the knee performed to identify the integrity of the anterior cruciate ligament

Clinical Significance – Place the patient’s knee in about 20-30 degrees flexion and externally rotated slightly. The examiner should place one hand behind the tibia and the other on the patient’s thigh. It is important that the examiner’s thumb be on the tibial tuberosity. On pulling the tibia anteriorly, an intact ACL should prevent forward translational movement of the tibia on the femur. A positive test is > 2mm of movement compared to the unaffected knee.

History – Named after John Lachman (1919-2007), who was an American orthopaedic surgeon and received his medical doctorate from the Temple University School of Medicine in 1945. He was described as a prolific teacher, mentor, and surgeon making his mark across students, faculty, and patients over illustrious career. As a testament to this, his eponymous test was published by one of his colleagues who named and attributed it to him in 1987.

References

1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
5. Up To Date. www.uptodate.com
6. Gurtler RA, Stine R, Torg JS. Lachman test evaluated. Quantification of a clinical observation. Clinical orthopaedics and related research. 1987; [pubmed]
7. Physiopaedia. Lachman Test. https://www.physio-pedia.com/Lachman_Test