A treatise on orthopedic surgery . some instancesthe swelling is uniform; in others it is localized in front orbehind one of the malleoli. This swelling is not, as a rule,like that of simple effusion into the joint, but the tissueshave the peculiar elasticity characteristic of thickening and in-filtration. There is usually a perceptible increase in the localtemperature, and pressure directly upon the malleoli causes dis-comfort. The voluntary movements of the joint are restricted,and passive movements show the characteristic reflex muscularspasm, limiting both dorsal and plantar flexion. DISEA
A treatise on orthopedic surgery . some instancesthe swelling is uniform; in others it is localized in front orbehind one of the malleoli. This swelling is not, as a rule,like that of simple effusion into the joint, but the tissueshave the peculiar elasticity characteristic of thickening and in-filtration. There is usually a perceptible increase in the localtemperature, and pressure directly upon the malleoli causes dis-comfort. The voluntary movements of the joint are restricted,and passive movements show the characteristic reflex muscularspasm, limiting both dorsal and plantar flexion. DISEASES AND INJURIES OF THE ANKLE-JOINT. 467 Subastragaloid —If the astragalus is primarily dis-eased, the symptoms are usually first apparent in the ankle-joint,but in certain cases the joint between the astragalus and the oscalcis is first involved. Disease at the subastragaloid joint isusually classed as ankle-joint disease, although the swelling ismost marked at a point somewhat below the malleoli (Fig. 311). Fig. Tuberculous disease of the subastragaloid joint. In this form forced lateral motion of the os calcis causes dis-comfort, and the range of adduction and abduction of the footis restricted, while dorsal and plantar flexion may be unre-stricted. Astragalo-navicular —If the disease is limited to thejoint the foot is usually fixed in an attitude of persistent ab-duction and as the process is usually of the subacute type itmay be mistaken for rigid weak foot. Diagnosis.—The principles of differential diagnosis of tuber-culous disease from other affections have been considered indetail in the description of disease of the larger joints. In childhood a chronic, painful disease confined to a single Fig. 312.
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
