Diseases of the joints and spine / by Howard Marsh.

  • Frederick Howard Marsh
Date:
1910
Catalogue details

Licence: In copyright

Credit: Diseases of the joints and spine / by Howard Marsh. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    35/684 page 11
    cases of acute arthritis is profuse, and the tendency of matter to track its way in the intermuscular spaces rather than to approach the surface is a marked and important feature. The destructive effects of this condition are shown in the accompanying figure (Fig. 1). The progress of a case such as this, unless energetic treatment is at once adopted, is generally from bad to worse. The usual result, as far as the joint is con- cerned, should the patient recover, is the formation of bony or close fibrous ankylosis. This is brought about as follows : The intensity of the inflammatory process subsides, and the production and multi- plication of cells become Limited; while the cells which remain in the various structures, whether bone, ligament, cartilage, or synovial membrane, become gradually developed into fibrous tissue, in which, where it is in contact with osseous tissue, bone-salts are sub- sequently deposited. The new blood-vessels shrink and disappear, the fibrous tissue which is not ossified con- tracts, and the joint, as such, ceases to exist, its cavity being entirely obliterated. In instances, however, in which treatment is adopted early, and in which the bones have not become exposed and carious, a more or less movable joint is left; while, should the secreting surface of the synovial membrane not have been destroyed, and should the cartilage and ligaments be still intact, the patient may preserve a useful and movable articulation, although some thickening and weakness remain. Symptoms.—In a typical case, one of punctured wound of the knee being the example selected for descrip- tion, a few hours after the injury the joint is the seat of pain, which soon becomes intense, especially on any attempt at movement, and of quickly increasing swell- ing. The temperature rises to 102° or 104°, the pulse to ] 10 or 120, and the patient feels ill and depressed.
    digitised image 1
    digitised image 2
    digitised image 3