Chronic rheumatic arthritis of the shoulder-joint / [Robert Adams].

  • Adams, Robert, 1791-1875.
Date:
[1849?]
Catalogue details

Licence: Public Domain Mark

Credit: Chronic rheumatic arthritis of the shoulder-joint / [Robert Adams]. Source: Wellcome Collection.

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    in this case to have advanced nearly so much in the shoulders as it had done in almost all the other joints of this individual. The under surface of the acromion had not as yet been laid bare; both shoulder-joints were symmetrically affected by disease, and in both the tendon of the biceps was similarly dislocated, and the head of the humerus drawn upwards. The glenoid cavity was but little altered in form, but its lower part had been completely abandoned by the head of the humerus. This portion (g) was denuded of all vestige of cartilage, and when the humerus was replaced as it lay during life, slightly rotated inwards, the vascular fimbrise(i) from the neck of the humerus lay in contact with this lower portion of the glenoid cavity, and were, no doubt, according to Mr. Key’s theory, the agents of the absorption of the cartilage. A process of dis¬ integration of the glenoid ligament had commenced. Any one who will take the trouble of comparing either of my specimens of the left or right shoulder-joints with that described by Mr. Soden, will, I imagine, conclude with me that they were all similar, and that they should be classed by pathologists in the same category. In Mr. So- den’s case it would appear that the disease (as I would call it) owed its origin to a fall, and might be considered local, although the man was of “ a rheumatic habit:” in the case ofMailly chronic rheumatic arthritis existed in all the joints. Upon the whole, although Mr. So- den’s case was for a long time to me an enigma which I could not solve, I conjectured that it was to be accounted for only by refer¬ ring it to the results of chronic rheumatic arthritis induced in the first instance by an accidental fall; yet until I met with the case of Mailly, I was not satisfied that I understood it fully; but now I feel perfectly convinced in my own mind, that this case of Mr. Soden’s must hereafter be looked upon as the result of those changes induced by chronic rheumatic arthritis. Upon looking at the preparation preserved in the Museum of the King’s College, of Mr. Soden’s case, it will be found that the head of the humerus is enlarged and of an abnormal figure. It may also be noticed that the tendon of the biceps is in a commencing state of atrophy, diminished some¬ what below the normal size. THE END.