Diseases of bones and joints (1914) (14571228840)

Syphilis of the wrist
Identifier: diseasesofbonesj00elyl (find matches)
Title: Diseases of bones and joints
Year: 1914 (1910s)
Authors: Ely, Leonard Wheeler, 1868-
Subjects: Bones Joints Diagnosis, Radioscopic Bone Diseases Joint Diseases Radiography
Publisher: New York : Surgery Publishing Company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School



Text Appearing Before Image:
Fig. 43. Same case as Figs. 41 and 42, after two injections of salvarsanand a course of mercurial inunctions. Note the improvement inthe tibial epiphysis, and the gouged-out appearance in the femoralepiphysis. Skiagram taken four months after the preceding. Theclinical improvement was marked, and the joint was practically well,except for a moderate restriction of motion, which was slowly im-proving. be more difficult. If the patient were an adult male,and gave a history of a urethral inflammation ator about the time of the onset of the joint trouble,and if two or three joints were involved, the pre- 96 DISEASES OF BONES AND JOINTS sumption of a gonococcic joint would be strong. Ifan examination of the urine revealed shreds (sil-ver threads among the gold, so to speak) or gono-cocci, a tentative diagnosis of a gonorrheal jointwould be justifiable. On the other hand we mustnot forget that a patient with chronic gonorrhea
Text Appearing After Image:
Fig. 44. Syphilis of the wrist, erroneously treated as tuberculosis. Ob-serve the stump of the amputated finger. For a full descriptionof this case, see Medical Record, 1912, LXXXI, 1179. Skiagramtaken Sept. 6, 1910. might have a tuberculous joint, or that a patientwith pulmonary tuberculosis might have a gonor-rheal arthritis (see Fig. 40), or that even a childmight quite innocently have a gonorrheal joint.Syphilitic arthritis can often be diagnosed only by DISEASES OF BONES AND JOINTS 97 finding some other evidence of syphilis in the body,by the presence of a broken-down gumma in thebone end (chronic gonorrheal arthritis probablynever ends in suppuration unless as a result of op-eration) by the Wasserman reaction, or eventuallyby a therapeutic test.