Holmblad Variations

摘要

In Chicago during the summer of 1936, Edward C Holmblad, M.D, was perplexed about the complexities involved in making an accurate knee diagnosis He was concerned because specific pathologic conditions of the knee, though clinically present, did not show up on the x-ray studies Specifically, he often suggested that "joint mice" could not be demonstrated on the traditional posteroanterior (PA) and lateral views. He attributed this problem to the overlapping shadow of the patella and the complex anatomy of the distal femur Specifically, the intercondylar notch located posteriorly between the 2 distal condyles of the femur made it difficult to visualize osteophytes and "joint mice" in this region He was frustrated because fractures involving the tibial spines and the proximal portion of the tibia were hard to evaluate radio-graphically He approached this problem with the hope of improving the way radiographs of the knee were performed As a result, in February 19.37 Holmblad's research culminated in the Holmblad method, a position that is still known today.