Panhypopituitarism after Cured Tuberculous Meningitis

claim may well be indefensible. The cost of cases of this sort to the medical defence organizations is considerable; the reputation of the surgeon is tarnished; and, most important of all, the patient suffers an avoidable permanent disability. The remedy is simple. Routine x-ray examination of the hips and pelvis should be made before any treatment is given for a sizable injury to a lower limb sustained in a violent accident such as a road traffic accident. The surgeon must not expect that the patient will identify for him the nature and positions of his injuries. The proximal injury in the region of the hip or pelvis is commonly painless or relatively painless in comparison with the pain of the more obvious distal injury. The lesson should have been learned by now, but it has not. This letter has been written to encourage the idea that routine x-rays of the pelvis and hips should be taken to exclude " the proximal injury."I am, etc.,