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Clinically, loose bodies composed of fibrin constitute an unimportant addition to the features of the disease with which they are associated. They never give rise to the classical symptoms associated with impaction of a loose body between the articular surfaces.
Acute arthritis may be septic or aseptic, and there seems to be a remarkable tendency for recovery in cases of septic arthritis involving this joint in the horse. Chronic arthritis with destruction of articular surfaces and ankylosis, is seldom observed.
The upper three-quarters of the anterior articular surface of the calcis is not in contact with the cuboid, the latter being depressed obliquely forward and downward, the lower portion of the posterior facet on the cuboid articulating with a new surface on the under portion of the bone.
#Pneumococcal affections of joints#, the result of infection with the pneumococcus of Fraenkel, are being met with in increasing numbers. The local lesion varies from a synovitis with infiltration of the synovial membrane and effusion of serum or pus, to an acute arthritis with erosion of cartilage, caries of the articular surfaces, and disorganisation of the joint.
The characters of this type of loose body are remarkably constant. The body is sometimes found to be lodged in a defect or excavation in one of the articular surfaces, usually the medial condyle of the femur, from which it is readily shelled out by means of an elevator. It presents on section a layer of articular cartilage on the convex aspect and a variable thickness of spongy bone beneath this.
The symptoms manifested by the subject in such cases are the same as have been discussed heretofore and merit no special consideration. Prognosis. Unless very serious injury be done the articular portions of the scapula or the humerus, resulting in the destruction of the capsular ligament, prognosis is entirely favorable. Open Joint.
The pressure of the articular surfaces against one another favours the progress of ulceration of cartilage and of articular caries. These processes are usually more advanced in the areas most exposed to pressure for example, in the hip-joint, on the superior aspect of the head of the femur, and on the posterior and upper segment of the acetabulum.
In acute arthritis, all the structures of the joint are involved; the articular cartilage is invaded by granulation tissue derived from the synovial membrane, and from the marrow of the subjacent bone; it presents a worm-eaten or ulcerated appearance, or it may undergo necrosis and separate, exposing the subjacent bone and leading to disintegration of the osseous trabeculæ caries.
Under such conditions it is very probable that imperfect metabolism of body tissue occurs, and certain toxic products that are capable of irritating the muscles and articulations form. Clinical symptoms, and the presence of bacteria in the inflamed tissue indicate that bacteria and their toxins play an important part in the development of articular rheumatism.
The ends of the bones are usually enlarged and have specially formed projections or depressions which fit into corresponding depressions or elevations on the bones with which they articulate. In addition to this the articular surfaces are quite smooth and dense, having no Haversian canals, and they are covered with a layer of cartilage.
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