Lectures on orthopedic surgery . Fig. 184.—Cannot abduct the arm without pain. results from an injury, but does not immediately followthe acute symptoms; it is always worse after exercise;and is not accompanied by general rheumatism. Withosteoarthritis it should rarely be confounded; it neverresults in destruction or eburnation of joint-surfaces;rest never tends to stiffen, but always loosens the joint; 225 it presents none of the characteristic symptoms of osteo-arthritis, and its clinical course has nothing in commonwith it. The patient may complain fitfully, often inaccord with atmospheric
Lectures on orthopedic surgery . Fig. 184.—Cannot abduct the arm without pain. results from an injury, but does not immediately followthe acute symptoms; it is always worse after exercise;and is not accompanied by general rheumatism. Withosteoarthritis it should rarely be confounded; it neverresults in destruction or eburnation of joint-surfaces;rest never tends to stiffen, but always loosens the joint; 225 it presents none of the characteristic symptoms of osteo-arthritis, and its clinical course has nothing in commonwith it. The patient may complain fitfully, often inaccord with atmospheric conditions; but it should beremembered that patients with fractures, injured mus-cles, and wounds often complain more in threateningweather. The arm is held closely to the side; pain iscomplained of over the joint and often at the insertion. Fig. 185.—Pain in trying to put the arm behind the back. of the deltoid muscle; the patient is unable to sleepupon the shoulder, and should he accidentally lie uponit he awakens with pain; acute pain is experiencedupon pressing a point just below and to the outside ofcoracoid process which corresponds to the front of thehumerus. There is an inability to rotate the joint either 226 inwards or outwards without discomfort. Abduction islimited, and elevation of the arm impossible. The sur-geon, in short, elicits from the patient the followingstory : My arm is weak and painful: I dare not lieupon it at night, or the pain becomes incessant; I can-not lift it from my side beyond a short distance; it
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectorthopedics, bookyear
