The Classic: Inflammation of the Post-calcaneal Bursa Associated with Exostosis

Charles Fairbank Painter was born in Grand Haven, Michigan, the son of a clergyman [1]. He evidently spent one year at Williams College, then went to Johns Hopkins University. He obtained his medical education at Harvard Medical School, from which he graduated in 1895 (in the same class with Harvey Cushing and E. Amory Codman). While a house officer at the Massachusetts General Hospital he became interested in orthopaedic surgery. He taught at both Harvard and Tufts and in 1913 became Dean of the Medical School of Tufts College. As with many prominent orthopaedists of the time, he served in the military during WWI, as the orthopaedic surgeon to the Chelsea Naval Hospital. At various times he practiced at the Robert Breck Brigham Hospital, the House of the Good Samaritan, the Beth Israel Hospital, the Massachusetts’s Women’s Hospital, and the Carney Hospital. Dr. Painter not only produced a large number of scholarly works (including his contributions as coeditor of Diseases of the Bones and Joints with Drs. Joel E. Goldthwait and Robert B. Osgood in 1910 [2]), but was active in community and national orthopaedic organizations. He was librarian of the Boston Medical Library for 8 years. He served as President of the American Orthopaedic Association in 1916, and in 1943 served as acting editor of The Journal of Bone and Joint Surgery after the death of the editor, Dr. Murray S. Danforth. He published a number of articles, but seemed particularly interested in arthritis and inflammatory and infection conditions. He wrote an early description of myositis ossificans in 1909 (and commented, ‘‘It is likely to be a long time before the medical profession will be in a position to offer the sufferer from myositis ossificans any material aid.’’) [4]. His earliest publication relates to the topic of this month’s symposium, ‘‘Molecular and Clinical Developments in Tendinopathy.’’ Published three years after his graduation from medical school, ‘‘Inflammation of the Post-calcaneal Bursa Associated With Exostosis’’ [3] reflects the thinking of the time. The concept of inflammation in tendons unassociated with tuberculosis or syphilis or rheumatic condition was not well developed in the late 1800s and early 1900s. However, most of the eight cases he described had long-standing pain and symptoms and signs of inflammation about the Achilles tendon. Perhaps owing to the radiographic appearance of exostoses, Painter directed his attention to that feature. (X-rays had just been discovered by Roentgen in November, 1895 [6]; it is remarkable little more than two years later the use of roentgenograms in clinical practice was widespread.) He stated, ‘‘It is possible to eliminate from the etiology influenza, scarlet fever, syphilis, gonorrhœa, acute Dr. Charles F. Painter is shown. Figure is 1947 by the Journal of Bone and Joint Surgery, Inc., and is reprinted with permission from Charles Fairbank Painter 1869–1947. J Bone Joint Surg Am. 1947;29:540–541.