Parrot's sign

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Parrot's sign
Historic image: frontal bossing in rickets
SpecialtyDermatology

Parrot's sign (19th century), refers to at least two medical signs; one relating to the skull and another to a pupil reaction.[1]

One Parrot's sign typically describes the bony growth noted at autopsy by Joseph-Marie-Jules Parrot [fr] and Jonathan Hutchinson on the skulls of children with congenital syphilis (CS) in the 19th century.[2][3] Later publications also refer to it as the frontal bossing that presents in the late type CS.[4][5] Initially thought to be indicative of congenital syphilis, it was noted to be present in other conditions, particularly rickets.[3]

Some 19th century textbooks also described the sign as the dilatation of a pupil when the back of the neck is pinched in some cases of meningitis.[6][7]

The sign is named for Marie Jules Parrot, a French physician in Paris, whose early work concentrated on the brain, followed by tuberculosis and later syphilis.[2]

Background

Parrot, Joseph Marie Jules (1829-1883)

Joseph-Marie-Jules Parrot was a French physician in Paris, whose early work concentrated on the brain, followed by tuberculosis and later syphilis.[2]

Skull

Parrot's sign,[4] also known as 'Parrot's nodes'[8] and 'Parrot's bosses',[9][10] refers to the bony growth noted at autopsy by Marie Jules Parrot and Jonathan Hutchinson on the skulls of children with congenital syphilis (CS) in the 19th century.[2][3] Later publications also describe it as the frontal bossing that presents in the late type CS.[4][5] Initially thought to be indicative of congenital syphilis, it was noted to be present in other conditions, particularly rickets.[3]

A description of bone findings in CS by Parrot was published in The Lancet in 1879 following his presentation at a meeting hosted by Jonathan Hutchinson and Thomas Barlow in London.[2] In 1883 Barlow referred to the overgrowth of skull bone seen in CS as 'Parrot's swellings' and 'Parrot's bosses'.[9] The nodes were said to be indicative of CS.[11] In Timothy Holmes' and Thomas Pickering 's A Treatise on Surgery: Its Principles and Practice (1889) it was noted that Parrot's nodes could co-exist with thinning bone in the same skull.[12] The nodes were described in Gray's Anatomy (1893) as appearing like buttocks or hot cross bun depending on which skull bones were affected.[13] According to D'Arcy Power in 1895, they were first reported by Parrot and Hutchinson, and also found in rickets, and therefore could not strictly make them indicative of congenital syphilis.[3] In Hamilton and Love's A Short Practice of Surgery (1959), Parrot's nodes were said to comprise of patches of periostitis in CS.[14]

Pupil

Parrot's sign was described in some ophthalmology textbooks of the 19th century as the dilatation of a pupil when the back of the neck is pinched in some cases of meningitis.[6][7]

See also

References

  1. ↑ Pryse-Phillips, William (2009). Companion to Clinical Neurology. Oxford University Press. p. 785. ISBN 978-0-19-536772-0. Archived from the original on 2023-07-01. Retrieved 2023-05-14.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Cole, Garrard; Waldron, Tony; Shelmerdine, Susan; Hutchinson, Ciaran; McHugh, Kieran; Calder, Alistair; Arthurs, Owen (October 2020). "The skeletal effects of congenital syphilis: the case of Parrot's bones". Medical History. 64 (4): 467–477. doi:10.1017/mdh.2020.41. PMID 3789442. Archived from the original on 2023-07-01. Retrieved 2023-05-12.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 Power, Sir D'Arcy (1895). "VII. Tumours of syphilitic disease of bone". The Surgical Diseases of Children: And Their Treatment by Modern Methods. Philadelphia: P. Blakiston. p. 155. Archived from the original on 2023-07-01. Retrieved 2023-05-12.
  4. ↑ 4.0 4.1 4.2 Harper, Kristin N.; Zuckerman, Molly K.; Harper, Megan L.; Kingston, John D.; Armelagos, George J. (2011). "The origin and antiquity of syphilis revisited: An Appraisal of Old World pre-Columbian evidence for treponemal infection". American Journal of Physical Anthropology. 146 (S53): 99–133. doi:10.1002/ajpa.21613. Archived from the original on 2022-12-24. Retrieved 2023-05-12.
  5. ↑ 5.0 5.1 Bhat M, Sriram (2019). "33. Miscellaneous". SRB's Manual of Surgery (6th ed.). Jaypee Brothers Medical Publishers. p. 1174. ISBN 978-93-5270-907-6. Archived from the original on 2023-07-01. Retrieved 2023-05-12.
  6. ↑ 6.0 6.1 Oliver, Charles Augustus (1895). Ophthalmic Methods Employed for the Recognition of Peripheral and Central Nerve Disease. University of Pennsylvania Press. p. 27. Archived from the original on 2023-07-01. Retrieved 2023-05-14.
  7. ↑ 7.0 7.1 Norton, Arthur Brigham (1898). Ophthalmic diseases and therapeutics (PDF) (2nd ed.). Philadelphia: Boericke & Tafel. p. 98.
  8. ↑ Stedman, Thomas Lathrop (2005). Stedman's Medical Eponyms. Baltimore: Lippincott Williams & Wilkins. p. 544. ISBN 0-7817-5443-7. Archived from the original on 2023-07-01. Retrieved 2023-05-12.
  9. ↑ 9.0 9.1 Barlow, Thomas (January 1883). "On Cases Described as "Acute Rickets" Which are Probably a Combination of Scurvy and Rickets, the Scurvy Being an Essential, and the Rickets a Variable, Element". Journal of the Royal Society of Medicine. MCT-66 (1): 159–219. doi:10.1177/095952878306600112. Archived from the original on 2023-07-01. Retrieved 2023-05-12.
  10. ↑ Thomson, Alexis; Miles, Alexander. Manual of Surgery Volume One. Libronomia Company. p. 207, 536. ISBN 978-1-4499-9483-9. Archived from the original on 2023-07-01. Retrieved 2023-05-12.
  11. ↑ Pepper, Augustus Joseph (1883). "34. Osseous lesions in congenital syphilis". Elements of Surgical Pathology. London: Cassell & Company. pp. 229–230. Archived from the original on 2023-07-01. Retrieved 2023-05-13.
  12. ↑ Holmes, Timothy (1889). "20. venereal diseases". In Pick, Thomas Pickering (ed.). A Treatise on Surgery: Its Principles and Practice (5th ed.). Philadelphia: Lea Brothers & Co. pp. 437–438. Archived from the original on 2023-06-30. Retrieved 2023-05-12.
  13. ↑ Gray, Henry (1893). Pick, T. Pickering (ed.). Anatomy, Descriptive and Surgical (13th ed.). Philadelphia: Lea Brothers & Co. p. 227. Archived from the original on 2023-07-01. Retrieved 2023-05-12.
  14. ↑ Bailey, Hamilton; Love, McNeill (1959). A Short Practice Of Surgery Eleventh Edition (11th ed.). London. p. 1221.

Further reading

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