Jonas Henrik Kellgren 1911–2002

P. J. L. Holt

Jonas Henrik Kellgren was the son of a Swedish father and Russian mother. He qualified from University College Medical School, London in 1934 and his early career was at this hospital as a research fellow with Sir Thomas Lewis. During this period he obtained both the MRCP and FRCS and published his seminal works on referred pain. The main points he made are relevant today, although he maintained, with some justification, that few people had really studied the principles he set out.

The onset of the Second World War interrupted his studies and he became a surgeon, initially at Great Ormond Street Children's Hospital and later in the Royal Army Medical Corps, where he obtained the rank of major and served both in North Africa and in the Italian campaign. After the war he joined the MRC staff at the Winfield Morris Orthopaedic Hospital in Oxford to continue his studies, now on peripheral nerve injuries.

In 1947 he reverted to a career as a physician and was appointed clinical director to the University of Manchester Centre for Research in Chronic Rheumatism. Kellgren was joined by Dr John Lawrence, who worked primarily as an epidemiologist involved in the study of rheumatism in the coal workers of Lancashire. This work was the foundation of the Arthritis and Rheumatism Council Field Unit, which has continued to prosper under a succession of directors.Go



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Kellgren was a keen observer of detail, particularly the topographical and distributional features of disease. From this he developed the concept of ‘nodal’ osteoarthritis and pointed out its often familial association. He also studied other conditions, particularly gout and ankylosing spondylitis. For the latter, he pointed out the benefit of exercise, in contrast to the rest recommended in other inflammatory arthritic diseases, and the value of localized ‘spot’ radiotherapy to the enthesis as distinct from the synovium. It was his interest in enthesopathy that spurred Professor John Ball, his pathologist colleague, to study this small but interesting inflammatory phenomenon with its unique location and ill-understood pathology. For this Kellgren obtained biopsies from patients, which Ball studied. He also encouraged Ball to study rheumatoid factor, which was coming into vogue in the early 1950s, and which culminated in Kellgren, Ball and Lawrence differentiating between the inflammatory arthropathies and conceptualizing the prognostic value of ‘seropositivity’ compared with ‘seronegativity’. From this period onwards Kellgren developed radiological criteria for the severity and progress of osteoarthritis, which are still pertinent today.

During his early period in Manchester the rheumatism centre was the sole reference point for clinical rheumatology in the region. Kellgren ran this and its extension at the Royal Devonshire Hospital, Buxton with the aid of colleagues, many of whom have gone on to obtain prominent positions in the profession.

He was a sympathetic and practical clinician in spite of his incisive approach to diagnosis. He always made a strong point of asking or determining what the patient's main requirements and expectations were; in the early post-war years this often involved the necessity to continue working at all costs. To achieve this objective he would use corticosteroids orally and by injection to relieve inflammation and pain. Later he initiated a study of the long-term effects of corticosteroid therapy.

In 1953, Kellgren was appointed Professor of Rheumatology at Manchester, the first such appointment in England. In his later career he spent a considerable amount of time developing a teaching programme for students, establishing outposts of teaching at district general hospitals throughout the North West, North Wales, the Isle of Man and even in Yorkshire and Staffordshire. Some of these were a formalization of practices already adopted by medical students where they found keen teachers able to give tuition and hands on experience to small groups. This made a major contribution to both undergraduate and postgraduate education in the region.

Kellgren later went on to be a major force in the development of the new medical school, where he was Dean from 1968 to 1973. This was an extended appointment. During part of this period (1969–1972) he was Pro-Vice Chancellor of the university.

Increasingly Kellgren's energies were devoted to national and international committees, such as the Flowers committee, which reviewed London medical schools and postgraduate institutes. He was also an expert adviser to the World Health Organization. He was President, Roundsman and Orator to the Heberden Society and finally an honorary member. He chaired international symposia, prinicipally on the epidemiology of rheumatic diseases, and gave several lectures to the Royal College of Physicians.

Kellgren, generally known as ‘Yonky’, was a slightly reserved person. Although economical with words, he could nevertheless produce a precise summary of the situation and the way forward.

He and Thelma spent their retirement in their cottage in the South Lakes.

Jonas Henrik ‘Yonky’ Kellgren, Professor of Rheumatology was born on the 11th September 1911 and died on the 22nd February 2002. He is survived by his second wife Thelma, who he married in 1942 and by their four daughters, and also by his daughter from his first marriage.





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