A treatise on orthopedic surgery . formation of cartilage and bone about the peripheryof the joint. The synovial membrane is hypertrophied, andmay be covered in places with calcareous plates; the contentsof the joint are usually increased in quantity. The joint disease often appears early in the course of loco-motor ataxia, before its existence is suspected. It is sometimescaused directly by injury but the predisposing cause is the lossof protection due to the hypotonia of the muscles and to thetittitude of hyperextension at the knees which is often habitual. In 246 cases of arthopathy analyze
A treatise on orthopedic surgery . formation of cartilage and bone about the peripheryof the joint. The synovial membrane is hypertrophied, andmay be covered in places with calcareous plates; the contentsof the joint are usually increased in quantity. The joint disease often appears early in the course of loco-motor ataxia, before its existence is suspected. It is sometimescaused directly by injury but the predisposing cause is the lossof protection due to the hypotonia of the muscles and to thetittitude of hyperextension at the knees which is often habitual. In 246 cases of arthopathy analyzed by Henderson^ 54 of thepatients were in the preataxic stage, 36 in the transitional andin 156 the ataxia was well marked. Charcots disease is said to affect about 5 per cent, of theataxic patients; it is more common in the lower extremity, andone or more joints may be involved. In the cases tabulated byFlatow the distribution was as follows: • Path, and Bact., 1905, v. 10. NON-TUBEBCULOUS DISEASES OF THE JOINTS. 297 Fig. Charcots disease of the knee-joint. A useful support in cases of this characteris illustrated in Fig. 205. Knee 60; in 13 cases both knees. Foot 30; in 9 cases both feet. Hip 38; in 9 cases both hips. Shoulder 27; in 6 cases both shoulders.* Cliipault notes the distribution in 217 cases, as follows: Knee 120 Hip 57 Foot 40 Fifteen cases of Charcots disease involving the spine havebeen reported.^ Symptoms.—The symptoms are the swelling due to the effu-sion, laxity of the ligaments, and deformity. There is prac-tically no local pain or sensitiveness, and the patients chief com-plaint is of the weakness and distortion of the limb. In certaincases the progress of the affection is very rapid, and the destruc-tion of bone may be so extensive that there is an actual luxationat the affected joint. Diagnosis.—If the patient is knowni to have locomotor ataxiathe diagnosis will be evident, and in any event the peculiar en-largement, and thickening of the tis
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