Encyclopædia Medica, Vol. 6
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Produktbeschreibung
Excerpt from Encyclopædia Medica, Vol. 6: Joints to Liver Arthritis is the term applied, when not only the synovial membrane, but all the joint structures are involved in the disease, viz. the ligaments, articular surfaces, and it may be also the ends of the bones. While it may be anatomically possible to differentiate between synovitis and arthritis, it is often impossible to do so clinically, so that in practice the two terms are often used indiscriminately. One may confidently speak of the existence of arthritis whenever there are marked symptoms of involvement of the articular surfaces. There are as many different pathological forms of arthritis as of synovitis, so that it is desirable in using the term to add a qualifying adjective which will indicate its nature, e.g. rheumatic, gouty, pyogenic, or tuberculous. The arthritis, according to its etiology, may assume a dry form, or it may be attended with effusion into the joint; this may be serous, as in arthritis deformans, or may be sero-fibrinous or purulent, as in certain forms of pyogenic and tuberculous arthritis. Wasting of the muscles in the vicinity of the joint is a constant accompaniment of arthritis; it especially affects the extensor muscles, and is quantitative rather than degenerative; the muscles affected do not show the reaction of degeneration. From the involvement of the articular surfaces it is unusual to have complete recovery from arthritis; it is apt to result in one or other form of ankylosis. Empyema is the term occasionally employed to indicate that the cavity of the joint is full of pus; it is chiefly observed in chronic suppurative disease of pyogenic or tuberculous origin, and is usually attended with the formation of abscesses outside the joint. "Ulceration of cartilage" and "caries of the articular surfaces" are common accompaniments of the more serious and progressive forms of joint disease, and especially those of bacterial origin. They represent successive stages in the same destructive process, the disappearance of the cartilage being frequently followed by exposure and disintegration of the subjacent bone. The changes which precede and follow upon the ulceration of the cartilage vary with the joint disease of which it is an accompaniment; their consideration is beyond the scope of the present article. The occurrence of ulceration of cartilage and of articular caries is always attended with characteristic clinical features, viz., the joint is held rigid by the involuntary contraction of muscles, the wasting of muscles is more pronounced, and there are "starting pains" at night. Advanced articular caries is usually associated with some deformed attitude, with shortening, and sometimes with dislocation. It may be possible under anaesthesia to make the exposed and crumbling bony surfaces grate upon one another. Should recovery take place repair will usually be attended with fusion of the opposing articular surfaces by fibrous tissue or by bone. Disorganisation of a joint is a convenient description of the condition in which all the constituent parts are damaged or destroyed. It results from the more severe and destructive forms of joint disease, and especially those of pyogenic or tuberculous origin. Conditions of Impaired Mobility of Joints. - (1) Rigidity implies the fixation of a joint by the involuntary contraction of muscles; it is sometimes called false ankylosis, because it entirely disappears under anaesthesia. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com
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