John Thomas sign

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Positive John Thomas sign displayed by a patient who sustained a pertrochanteric fracture on the left.

The John Thomas sign,[1] also known as the Throckmorton sign,[2] is a slang or joke term used in the field of radiology. It refers to the position of a penis as it relates to pathology on an x-ray of a pelvis. When the penis (visible on the x-ray as a shadow) points towards the same side as a unilateral medical condition such as a broken bone, this is considered a "positive John Thomas sign", and if the shadow points to the other side, it is a "negative John Thomas sign."[3]

Studies have shown that the "sign" is no better than chance at identifying the location of a hip fracture.[4][5] In those cases where the John Thomas sign is positive, it has been proposed that a person with a displaced hip fracture may try to lie on the injured side to immobilize the fracture and reduce pain; the penis then inclines toward the downward (injured) side.[6]

Andy Murray, British professional tennis player, released a picture of his pelvic X-ray following his hip resurfacing surgery on 29th January 2019[7] clearly demonstrating an example of a negative John Thomas or Throckmorton sign where his penis pointed away from the site of injury. The release of the X-ray image with visible genitalia was discussed by Piers Morgan on Good Morning Britain (2014 TV programme) prompting Murray, who was watching at the time, to message the show, stating, “Please can you stop discussing my genitals on national TV, I was heavily medicated at the time of posting.”[8]

References[edit]

  1. ^ "Note: "John Thomas" is an English language euphemism for "penis"
  2. ^ "Throckmorton sign". Radiopaedia. Retrieved 12 June 2015. The Throckmorton sign is reportedly named for American neurologist Tom Bentley Throckmorton (1885-1961).
  3. ^ Thomas MC, Lyons BD, Walker RJ (1998). "John Thomas sign: common distraction or useful pointer?". Med. J. Aust. 169 (11–12): 670. PMID 9887926.
  4. ^ Murphy, IG; Murphy CB; Hefferman EJ (April 2014). "John Thomas sign--a memorable but misleading sign in hip fractures". Orthop Traumatol Surg Res. 100 (2): 199–202. doi:10.1016/j.otsr.2013.12.017. PMID 24582209.
  5. ^ Jeys, Lee M.; Holton, Colin (23 December 2000). "Yorkshire men straight to the point, or not? Validation of the John Thomas Sign". British Medical Journal. 321 (1609).
  6. ^ Mouzopoulos GJ, Stamatakos MK, Mouzopoulos DJ (2007). "Does penis radiological shadow indicate the side of hip fracture?". J Postgrad Med. 53 (3): 217. doi:10.4103/0022-3859.33873. PMID 17700004.
  7. ^ "Social media users spot more than Andy Murray's new hip in X-ray". Evening Standard. 2019-01-29. Retrieved 2019-01-30.
  8. ^ "Andy Murray tells Piers Morgan to 'stop discussing his genitals' after X-ray". Metro. 2019-01-30. Retrieved 2019-01-30.