Sister (Mary) Joseph's Nodule
Authors: David P. Steensma
Journal: Annals of Internal Medicine (2000)

Letters1 August 2000Sister (Mary) Joseph's NoduleDavid P. Steensma, MDDavid P. Steensma, MDMayo Clinic; Rochester, MN 55905 (Steensma)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-3-200008010-00022 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Several authors have criticized the use of the word “Mary” in “Sister (Mary) Joseph's nodule,” the periumbilical mass that sometimes accompanies an intra-abdominal or pelvic cancer (1, 2). The nodule is named after pioneer surgeon William J. Mayo's brilliant first assistant, who could predict malignant findings at laparotomy if she felt an umbilical mass while scrubbing the abdomen (3). Mayo first reported the condition as “pants-button umbilicus” (without credit to Sister Mary Joseph) in a lecture to the Cincinnati Academy of Medicine in 1928, and the Sister's name was attached to the phenomenon by Hamilton Bailey in 1949 (4). One physical diagnosis textbook summarizes a current prevailing opinion: “This node is often called, incorrectly, Sister Mary Joseph's nodule, perhaps because Sister Joseph was the superintendent at St. Mary's hospital, a unit of the early Mayo Clinic, or because Catholic nuns have traditionally taken the name of Mary in addition to another name” (5).Archival evidence at the Mayo Clinic contradicts this view. The Figure is reprinted from a 1902 listing of the hospital staff of St. Mary's Hospital in Rochester, Minnesota. Published by the founders of the first Mayo-associated hospital, the Sisters of St. Francis of the Congregation of Our Lady of Lourdes, this document demonstrates that the original “charge” nurse at St. Mary's was known among the hospital staff as “Sister Mary Joseph.” Her name continued to be listed both in this fashion and as “Sister Joseph” on hospital reports and correspondence until her death in 1939. Therefore, either eponym for the enlarged periumbilical node (Sister Joseph or Sister Mary Joseph) is acceptable.Figure 1. 1902 listing of the staff of St. Mary's Hospital in Rochester, Minnesota, from the 13th Annual Report of the institution.Sister Mary Joseph served as charge nurse and hospital superintendent from the 1890s until her death in 1939. Download figure Download PowerPoint In a testament to how health care has changed in the past century, the current incarnation of the Figure, the Quarterly Directory of the staff of the Mayo Clinic, is 544 pages long and contains more than 32 000 names!References1. Schwartz IS. Sister (Mary?) Joseph's nodule [Letter]. N Engl J Med. 1987;316:1348-9. CrossrefMedlineGoogle Scholar2. Viera AJ, Clenney TL. Sister (Mary?) Joseph's nodule [Letter]. Am Fam Physician. 1999;59:2984. MedlineGoogle Scholar3. Hill M, O'Leary JP. Vignettes in medical history: Sister Mary Joseph and her node. Am Surg. 1996;62:328-9. MedlineGoogle Scholar4. Bailey H. Demonstrations of Physical Signs in Clinical Surgery. 11th ed. Baltimore: Williams & Wilkins; 1949:227. Google Scholar5. Sapira JD. The Art and Science of Bedside Diagnosis. Baltimore: Williams & Wilkins; 1990:143. Google Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Mayo Clinic; Rochester, MN 55905 (Steensma) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByUmbilical Lesions: Clinicopathologic Features of 99 TumorsInspection of the AbdomenAn ovary as unusual contents of an incarcerated umbilical herniaSister Mary Joseph’s Nodule as the First Sign of Pancreatic CarcinomaSister Mary Joseph NoduleInspection of the AbdomenWhat the heck is this new periductal hypoechoic sign?Sister Mary Joseph's NoduleUmbilical endometriosisInspection of the Abdomen 1 August 2000Volume 133, Issue 3Page: 237KeywordsHealth careLaparotomyNursesSurgeons Issue Published: 1 August 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...