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If daily injections are necessary, dilution of the tincture of iodin with an equal amount of alcohol is advisable in order to avoid doing irreparable damage to the articular cartilages and synovial membranes. An antiseptic powder composed of equal parts of boric acid and exsiccated alum is employed to protect the wound surfaces and the margins, and the parts are then bandaged.
The origin of these bodies is one of the most debated questions in surgical pathology; they obviously consist of a portion of the articular surface of one of the bones, but how this is detached still remains a mystery; some maintain that it is purely traumatic; König regards them as portions of the articular surface which have been detached by a morbid process which he calls "osteochondritis dessicans."
The destruction of cartilage may be secondary to disease of the synovial membrane or of the subjacent bone. When the disease begins as a synovitis, the synovial membrane spreads over the articular surface, fuses with the cartilage and eats into it, causing defects or holes which are spoken of as ulcers.
The slightest movement causes pain, and the part is sensitive to touch. The skin is hot and tense, and in the case of the elbow may be red and fiery as in erysipelas. The deposit of fibrin on the synovial membrane and on the articular surfaces may lead to the formation of adhesions, sometimes in the form of isolated bands, sometimes in the form of a close fibrous union between the bones.
The affected muscle or articulation may be swollen, hot and tender. Pressing on the part with the hand or forcing the animal to move about may cause severe pain. Weakness and emaciation may occur in generalized and articular rheumatism, especially if suppuration takes place in the affected joint. The prognosis is more favorable in muscular rheumatism than in the articular form.
One of the manifestations of gout is that certain joints are liable to attacks of inflammation associated with the deposit of a chalk-like material composed of sodium biurate, chiefly in the matrix of the articular cartilage, it may be in streaks or patches towards the central area of the joint, or throughout the entire extent of the cartilage, which appears as if it had been painted over with plaster of Paris.
The joints affected in the articular form are the knee, fetlock, hip, elbow and shoulder. The attack is usually sudden and accompanied by fever, more or less loss of appetite and soreness. Loss of control over the movement of the hind parts or walking on the knees may occur in the smaller animals. The larger animals show a slight or severe lameness.
Fractures of the neck of the scapula are serious because of the fact that there occurs displacement of the broken parts and perfect apposition of the fractured ends is difficult, if not impossible. Fractures that extend to the articular surface are very serious, and complete recovery in such instances is practically impossible.
A case of this nature is described, the patient being a raftsman, aged seventeen, who suffered with inflammatory symptoms of the right great toe, which were followed in the next ten years by progressive involvement of all the joints of the extremities, and of the vertebrae and temporo-maxillary articulations, with accompanying signs of acute articular rheumatism.
At best, one can only hope for partial recovery, that is to say, the member may regain its usefulness as a weight-supporting part, but because of restricted or abolished joint function, locomotion is more or less difficult. Exostoses, articular and periarticular, occur and the carpus usually becomes a large immobile articulation.
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