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Outward displacement is comparatively rare. The causes of "stifle out" may be described as follows: The patella or knee-cap rests on a pulley-like articular surface belonging to the inferior extremity of the thigh-bone. The external lip of this articular surface is smaller than the internal lip.
The fusion of the cartilaginous surfaces is preceded by the spreading of a vascular connective tissue, derived from the synovial membrane, over the articular cartilage. It may follow upon fibrous or cartilaginous ankylosis, or may result from the fusion of two articular surfaces which have lost their cartilage and become covered with granulations.
If the disease is not arrested, there follow the symptoms and signs of involvement of the articular surfaces. Influence of Tuberculous Joint Disease on the General Health. Experience shows that the early stages of tuberculous joint disease are compatible with the appearance of good health.
The completeness of the analgesia of the articular structures and of the overlying soft parts is illustrated by the fact that in one case the patient himself was in the habit of letting out the fluid from his elbow with the aid of a pair of scissors, and that in another the joint was painlessly excised without an anæsthetic.
The condyles of the humerus articulate with the glenoid cavities of the radius and a portion of the ulna. Two strong collateral ligaments pass from the distal end of the humerus to the head of the radius. The capsular ligament is a large, loose membrane which encloses the articular portion of the humerus with the radius and ulna and also the radioulnar articulation.
The early recognition of periosteal lesions in the articular ends of bones is of importance, as the disease, if left to itself, is liable to spread to the adjacent joint. The treatment is that of tuberculous lesions in general; if conservative measures fail, the choice lies between the injection of iodoform, and removal of the infected tissues with the sharp spoon.
Was the lack of a higher civilization and more ardent love for freedom really the cause, then, for Ireland's undergoing so many fearful sacrifices merely for the sake of her religion? We should not dread entering upon a comparison of the Scandinavian and Celtic races in these two articular points, as they existed at the time of the Tudors.
Arthritis is the term applied when not only the synovial membrane but the articular surfaces, and it may be also the ends of the bones, are involved, and it is necessary to prefix a qualifying adjective which indicates its nature. When effusion is present, it may be serous, as in arthritis deformans, or sero-fibrinous or purulent, as in certain forms of pyogenic and tuberculous arthritis.
There is no chance for complete recovery in the usual case of carpal fracture because of the fact that there results sufficient arthritis to destroy articular cartilage beyond repair. In the average instance, because of arthritis which persists for a considerable length of time, more or less ankylosis results.
"Nathusius has shown that, with the improved races of the pig, the shortened legs and snout, the form of the articular condyles of the occiput, and the position of the jaws with the upper canine teeth projecting in a most anomalous manner in front of the lower canines, may be attributed to these parts not having been fully exercised.... These modifications of structure, which are all strictly inherited, characterise several improved breeds, so that they cannot have been derived from any single domestic or wild stock.
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