. Diseases of bones and joints . than andothers as Metabolic Osteo-Arthritis, and by otherwriters by various other appellations. It includesalso some of the cases recently described under theheading Infectious Arthritis. As the view isgaining ground that all these joint diseases areprobably of infectious origin, it seems unwise toseparate a special class under that name, implyingthat others are of different JOINT TUBERCULOSIS. Etiology. The exciting cause is the tubercle ba-cillus. Heredity, environment, trauma and the acute 1 Certain writers would make another type which they wouldte
. Diseases of bones and joints . than andothers as Metabolic Osteo-Arthritis, and by otherwriters by various other appellations. It includesalso some of the cases recently described under theheading Infectious Arthritis. As the view isgaining ground that all these joint diseases areprobably of infectious origin, it seems unwise toseparate a special class under that name, implyingthat others are of different JOINT TUBERCULOSIS. Etiology. The exciting cause is the tubercle ba-cillus. Heredity, environment, trauma and the acute 1 Certain writers would make another type which they wouldterm infectious. In the present condition of our knowledge itseems better to restrict this term to conditions associated with adefinite organism.—McCrae. DISEASES OF BONES AND JOINTS 43 infectious diseases have all been considered as con-tributing causes. The influence of trauma hasprobably been overrated, and, as we shall see inour study of the pathology, those cases which startin the bone marrow cannot be influenced in the be-. Fig. 16. Photomicrograph of synovial tuberculosis of the adult knee—slow,chronic form, with well-marked production of fibrous tissue. Thedisease had existed with desultory treatment, for many years, andwas completely cured by the authors resection three years patient now is in health. T—tubercles, well encapsulated bynew fibrous tissue. The structure above is an hypertrophied syno-vial villus. Zeiss apochromatic 16 mm. ginning by trauma, for the marrow is shielded fromany force other than fracture. Trauma may, how-ever, bear a more direct causal relation to the casesstarting in the synovia. Trauma 44 DISEASES OF BONES AND JOINTS In a large proportion of instances one of theacute infectious diseases precedes the onset of jointtuberculosis, especially among children. Measlesranks first, then whooping cough, then scarlet feverand pneumonia.
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