The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . theosteitis has begun very near the joint surface; perhaps that necrosis has eveninvolved the articular lamella ; that the cartilage has suddenlv given way, andthat pus, with other inflammatory matters, has been poured into the joint. The slow form of disease first de|>icted, and also the latter, more rapidmalady, if the first violence be overpassed, leave the soft and hard constituentsof the joint granulating and suppurating; abscesses open to the surface, andsinus-mouths, crowned with
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . theosteitis has begun very near the joint surface; perhaps that necrosis has eveninvolved the articular lamella ; that the cartilage has suddenlv given way, andthat pus, with other inflammatory matters, has been poured into the joint. The slow form of disease first de|>icted, and also the latter, more rapidmalady, if the first violence be overpassed, leave the soft and hard constituentsof the joint granulating and suppurating; abscesses open to the surface, andsinus-mouths, crowned with large granulations, perforate the skin. Thesesinuses and abscesses difter a good deal in their appearance, according as theosseous disease is a caries or a necrosis. In the case of canes, the pus is thin,irritating, and cojiious; the sinus-mouth, some distance from the seat of dis-ease, is crowned by large florid granulations, of a peculiarly brilliant color,and bleeding very easily; the akin around is tightly drawn, of a bluish shade, For symptoms see p. 282. 364 DISEASES OF THE JOINTS. Fig. ( and looks tliin; the sinus is tortuous, wlicuce there may be difficulty iutouthiiii!: tlic <liseaseJ surtace with a jirobe, and when the carious surface istouched^ a tlvsh iiow of blood ensues. When the disease is /tcrroi-fs, the pus, iK^t large in (juantity, is nearly laud-able ; thegranulationssurrounding thesi-nus-niouth are large, Habby, and not verybiilliant, and do not bleed with extremereadiness; the skin around is normal;the sinus is short and fairly straight;the diseased bone does not bleed on con-tact with the probe. A peculiarity ofthe abscess-openings in children, whichis, I believe, due to the slow foi-mationof pus, and which I have been accus-tomed to connect with fatty osteitis, isdetachment of the skin for a long distancearound the ojjening. The same thing oc-curs to the skin over suppurating tuber-cular glands of the neck. One may passa probe introduced through
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