A treatise on orthopedic surgery . fearly adult life than of old age. It is more common amongfemales than males. It is more acute in its onset, more rapidlyprogressive, and more general in its distribution than thetypical hypertrophic form. In hypertrophic arthritis the cartilage is worn away at thecentre of the joint, heaped up at the periphery and the under-lying bone is involved. In typical atrophic arthritis the affec-tion is primarily of the fibrous coverings and of the membranesof the joint, and the cartilage is destroyed in the later stages bya pannus-like growth from the periphery. The
A treatise on orthopedic surgery . fearly adult life than of old age. It is more common amongfemales than males. It is more acute in its onset, more rapidlyprogressive, and more general in its distribution than thetypical hypertrophic form. In hypertrophic arthritis the cartilage is worn away at thecentre of the joint, heaped up at the periphery and the under-lying bone is involved. In typical atrophic arthritis the affec-tion is primarily of the fibrous coverings and of the membranesof the joint, and the cartilage is destroyed in the later stages bya pannus-like growth from the periphery. There is secondaryerosion of the cartilage and of the underlying bone unaccom- 288 ORTHOPEDIC SUBGEBY. panied by the hypertrophy characteristic of the preceding dis-ease. A spindle-shaped enlargement of the finger-joints is char-acteristic, but the X-ray picture will not show irregular bone for-mation but a normal contour or at most superficial erosions of thebones entering into the formation of the joint. The second inter- FiG. Atrophic arthritis in a child, showing the characteristic deformity,every joint in the body is involved. Nearly phalangeal joints are usually involved primarily. There is usuallyflexion contraction, and in many instances general deviation ofthe fingers toward the ulnar side. In younger subjects, particu-larly in the class of cases in which the onset of the disease isacute, and in which there is considerable effusion, there may besubluxation or actual luxation of the phalanges, more often atthe metacarpal articulations, combined with more or less absorp-tion of the extremities of the bones. In such instances motionis preserved in the affected joints. In typical cases the final result in any joint is either anchy-losis or limited motion accompanied by flexion is, of course, general atrophy of the muscles and of thebones corresponding in degree to the functional disability thatis present. The onset of atrophic arthritis may be acute, res
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
