A treatise on orthopedic surgery . manifestations of onepathological process, the titles are usually considered as syn-onymous. Clinically, however, the characteristic types differ markedlyfrom one another. In one form bone destruction is combinedwith bone formation, and the final result is an irregular solidenlargement of the joint, usually combined with distortion ofthe limb. The term hypertrophic arthritis may be applied to this type. The second form resembles chronic rheumatism in its courseand distribution. The joints are enlarged but the disease isessentially of the soft parts, the artic
A treatise on orthopedic surgery . manifestations of onepathological process, the titles are usually considered as syn-onymous. Clinically, however, the characteristic types differ markedlyfrom one another. In one form bone destruction is combinedwith bone formation, and the final result is an irregular solidenlargement of the joint, usually combined with distortion ofthe limb. The term hypertrophic arthritis may be applied to this type. The second form resembles chronic rheumatism in its courseand distribution. The joints are enlarged but the disease isessentially of the soft parts, the articulating surfaces are only Gyot, Eev. des Chir., xxiv., Nos. 2 and 4. NON-TUBEBCULOUS DISEASES OF THE JOINTS. 283 secondarily and superficially involved. There is no new forma-tion of bone or cartilage but eventually general atrophy of thelimb. The final result is deformity and limited motion or anchylosiswithout bony enlargement of the joint. This form may beclassed from the clinical standpoint as atrophic to distinguish Fig. Hypertrophic arthritis. The hypertrophy of the extremities of the bones ofthe terminal phalanges (Ileberdens nodes) is accompanied by erosion of the car-tilage. The second interphalangeal joint of the second finger shows hypertrophy;combined with destruction and lateral displacement. (See Fig. 194.) it from the former or hypertrophic form of arthritis deformansif this tenn is used to include both varieties. Hypertrophic Arthritis.—Pathology.—The characteristic typeis that seen in elderly subjects, sometimes limited to a singlejoint—Malum Coxse Senile, for example. The primary effects 284 ORTHOPEDIC SUSGEBY. of the disease are most noticeable in the cartilage, ^vhich becomesfibrillated and finally is worn away in the parts subjected togreatest pressure, while it is thickened and heaped up intoirregular layers at the periphery, as if under the influence ofpressure it had been squeezed out from the interior of the joint Fig. 194.
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