On dactylitis syphilitica : with observations on syphilitic lesions of the joints / by R.W. Taylor.

  • Taylor, Robert W. (Robert William), 1842-1908
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: On dactylitis syphilitica : with observations on syphilitic lesions of the joints / by R.W. Taylor. Source: Wellcome Collection.

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    Encliondi'oma of the fingers might possibly but rarely b(j mistaken for dactylitis syphilitica, but with care they can easily be differentiated, as the former involves generally one, and especially the palmar, surface of the bone, inci'eases very slowly, and presents a hard, well-defined tumor. The same remarks apply to exostoses. The second foi*m of dactylitis syphilitica might perhaps be mistaken for periostitis or the so-called strumous disease of bone. From the former it would be known by its comparative painlessness, its subacute course, and perhaps by the coinci- dence of syphilitic lesions of larger joints, with their well- marked symptoms as already detailed, as well as a history of syphilis, or the presence of tegumentar}'- lesions of syphilis upon the body. The tendency of the so-called strumous inflamma- tion to localize itself in bone rich in cancellous tissue, particu- larly those of the carpus and tarsus, and the expanded extremi- ties of long bones, renders it probable that it rarely if ever at- tacks the phalanges. prognosis of this affection of the fingers and toes depends entirely upon the accuracy of the diagnosis, and to a certain extent upon the period at which it is recognized, and in the event of its being correct, and as a consequence an appropriate treatment being instituted, it may be stated to be good, for the final impairment of the members is generally not so great as to cause ntter uselessness. But if the oi-igin of the lesion is not recognized, the chronic enlai'gement of the bone, the chronic hydrarthrosis with crepitation, or the latter symptom com- bined with chronic capsular thickening, might lead the nnwary surgeon to pronounce an nnfavorable prognosis, and perhaps to institute unnecessary operative procedure. The treatment is that of late syphilis, the nse of iodide of potassium either alone or combined with a mercurial. The combination always answers best in cases where there is a co-existence of tegumentai-y lesions, but Avhen these are strictly osseous and ligamentous, our chief reliance is upon the iodide, and we can, if that is in- efficient, add the mercury. When the parts are very much distended, a minute incision may be necessary.
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