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Because of the fact that these bones have proportionately large articular surfaces, when they are inflamed to the extent that degenerative changes affect the articular cartilage, complete recovery seldom results. The same pathological changes occur here that are to be seen in any case of arthritis.
Milne-Edwards who rightly compares these surfaces, as to their appearance, with articular surfaces, thinks that they serve to diminish the friction between the two feet.
Fourteen long quill feathers diverge on each side of the metacarpal and phalangial bones, and decrease in length from 6 inches to 1 inch. The wings have a general resemblance to those of gallinaceous birds. The tarso-metatarsal, or drumstick, exhibits at its distal end a trifid articular surface supporting three toes, as in birds.
Syphilitic diseases of bone are much less common in practice than those due to pyogenic and tuberculous infectious, and they show a marked predilection for the tibia, sternum, and skull. They differ from tuberculous affections in the frequency with which they attack the shafts of bones rather than the articular ends, and in the comparative rarity of joint complications.
The peripheral portion consists of soft sarcomatous tissue, which invades the overlying soft parts. The articular cartilage long resists destruction. The ossifying sarcoma is met with most often in the femur and tibia, less frequently in the humerus, skull, pelvis, and jaws. In the long bones it may grow from the shaft, while the chondro-sarcoma more often originates at the extremities.
The X-ray appearances of arthritis deformans necessarily vary with the type of the disease and the joint affected; in the joints of the fingers there is a narrowing of the spaces between the articular ends of the bones as a result of absorption of the articular cartilage, and rarefaction of the cancellous tissue in the vicinity of the joints; in the larger joints there is "lipping" of the articular margins, osteophytes, and other evidence of abnormal ossification in and around the joint.
On the patella it is attached around the margin of the articular surface, but on the femur the line of attachment is at a varying distance from the articular surface. On the medial side it is an inch or more from the articular cartilage; on the lateral side and above, about half an inch.
In all forms of incipient ringbone except rachitic, the first manifestation of its existence, or of injury to the ligaments in the region of the pastern joint which causes periostitis, or affections of the articular portions of the proximal inter-phalangeal joint, is lameness.
The shadow of the new case or involucrum with its wavy contour is also in evidence, with its openings or cloacæ, and is mainly responsible for the increase in the diameter of the bone. The skiagram may also show separation and displacement of the adjacent epiphysis and destruction of the articular surfaces or dislocation of the joint. Sequelæ of Acute Suppurative Osteomyelitis.
It differs from other inflammations by shifting from one part to another. It is termed muscular rheumatism when it affects the muscles, tendons and fascia, and articular rheumatism when it involves the articulations. A second classification, acute and chronic, depends on the character of the inflammation.
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