A treatise on orthopedic surgery . 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 exa
A treatise on orthopedic surgery . 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. Atrophic arthritis. Slight superficial erosions of the bones are to be seen atseveral of the joints. Contrast with Fig. 103. (Fig, 195). When the cartilage disappears, the bone, deprivedof its natural protection, is worn away, and under the influenceof pressure and friction it becomes increased in density andhardness, ebumated. Meanwhile the irregular projectionsof cartilage at the periphery become in part ossified, and this,together with a formative periostitis of the adjoining bone. NON-TUBEECULOUS DISEASES OF THE JOINTS. 285 causes the irregular bony enlargement combined with destruc-tion of the bearing surfaces of the bones characteristic of thedisease. The contour of the bones and their mutual relationto one another in the joint are changed. The synovial mem-brane becomes hypertrophied and its villi, some of v^hich maycontain cartilaginous nodules, project into the joint in shaggyfringes. These may be detached from time to time and mayform loose bodies within the capsule. The syn
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