A treatise on the principles and practice of medicine . ation (Haygarths nodosities); the joint surfacesbecome eroded and in part grow together. 1. Diffuse Progressive Type.—(a) The acute form is less is some fever, rise in the pulse-rate and general depression and thejoints become red and swollen, resembling acute articular rheumatism,but differing from it in that arthritis deformans is less fugitive, involvesthe small joints less frequently, is attended by less sweating, and seldomby heart complications, does not react to salicylates and runs a longercourse. In some cases it eve
A treatise on the principles and practice of medicine . ation (Haygarths nodosities); the joint surfacesbecome eroded and in part grow together. 1. Diffuse Progressive Type.—(a) The acute form is less is some fever, rise in the pulse-rate and general depression and thejoints become red and swollen, resembling acute articular rheumatism,but differing from it in that arthritis deformans is less fugitive, involvesthe small joints less frequently, is attended by less sweating, and seldomby heart complications, does not react to salicylates and runs a longercourse. In some cases it even resembles typhoid, because the fever andsplenic enlargement antedate the arthritis, (b) The more frequentchronic form develops insidiously, with uncomfortable sensations in thejoints or racking nocturnal pains about the joints and vasomotor skinsymptoms. It begins most often in the small joints of the hands, with orwithout swelling, and remits and recurs. The hands often sweat. Thefingers become fusiform from joint changes, capsular thickening and. Fig. 79.—Rheumatoid arthritis. (Musser.) collateral edema which separate the fingers from each other. The edemaoften disappears, showing more clearly the osseous and capsular thicken-ing. The cartilages become uneven and crackle on movement, loosenedvilli may become free bodies and the adjacent bursa? and tendons mayswell. The fingers deviate and become angular from flattening of thesaddle-shaped epiphyses and extensor or flexor muscular to other joints occurs; the elbow becomes flexed, the shoulderoften crackles and becomes fixed; the large toe is bent out and lies underthe other toes, which are often extended at their first and flexed at theirtwo distal articulations; the ankle is often abducted; the knee is swollen,shapeless and flexed from effusion or contracture; in a few cases the hip,jaw and spine are involved. The vertebrae may be affected (v. i.). Motion is limited by the swelling, muscular contr
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