Surgery.

Date:: [1913]

Catalogue details

Licence: In copyright

Credit: Surgery. Source: Wellcome Collection.

160/412 (page 134)

between bony prominences where the synovial membrane is least supported. X-ray in the early stages shows only widening of the joint line, and by the time destruction of the bone is obvious the diagnosis is not in doubt. In the early phase aspiration may be necessary to establish the diagnosis. What are the 'possible Terminations of Acute Arthritis ? (a) Resolution with only slight impairment of joint function. (b) Fibrous or bony ankylosis. (c) Contracture deformity. (d) Death from septicaemia or long-standing suppuration and amyloid disease. What is the Treatment ? {a) General constitutional measures as in septicaemia (Part I). (6) Support the limb and apply gentle traction to ease the pain and separate the joint surfaces. (c) In early cases aspirate the joint. If pus is present drain the joint. (d) Sulphanilamide or sulphapyridene are of value in streptococcal cases. (e) Amputation may be necessary to save life. Describe Pneumococcal Arthritis. This infection is a complication or sequel of pneumonia and may affect a single large joint or may be an incident in a pneumococcal septicaemia. In young children the arthritis may be so insidious that the first sign is pathological dis- location. In adults there is gross destruction of bone and ankylosis is the usual result. The diagnosis is made from acute arthritis by the history and by the bacteriological examination of the fluid. Treatment is that of acute arthritis plus the adminis- tration of sulphapyridene.