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This connection between trauma and arthritis deformans led Arbuthnot Lane to apply to it the term traumatic or trade arthritis. The traumatic or strain factor in the production of the disease may be manifested in a less obvious fashion.
Hydrops may occur apart from disease for example, in the knee-joint from repeated sprains, or when there is a loose body in the joint but is met with chiefly in the chronic forms of synovitis which result from gonorrhœa, tuberculosis, syphilis, arthritis deformans, or arthropathies of nerve origin.
They are not peculiar to joints, for they are met with in tendon sheaths and bursæ, and their origin from synovial membrane may be accepted as proved. They occur in tuberculosis, arthritis deformans, and in Charcot's disease, and their presence is almost invariably associated with an effusion of fluid into the joint.
The hands may become seriously crippled, especially when the tendon sheaths and bursæ also are affected; the crippling resembles that resulting from arthritis deformans but it differs in not being symmetrical.
The deformities resulting from chronic rheumatism are but little amenable to surgical treatment, and forcible attempts to remedy stiffness or deformity are to be avoided. Under the term arthritis deformans, which was first employed by Virchow, it is convenient to include a number of joint affections which have many anatomical and clinical features in common.
When the affection has lasted some time, or has frequently relapsed, the wall of the bursa becomes thickened by fibrous tissue, which may be deposited irregularly, so that septa, bands, or fringes are formed, not unlike those met with in arthritis deformans.
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.
The majority of the lesions appear to have been the common osteo-arthritis, which involved not only the men, but many of the pet animals kept in the temples. In a much higher proportion apparently than in modern days, the spinal column was involved. It is interesting to note that the "determinative" of old age in hieroglyphic writing is the picture of a man afflicted with arthritis deformans.
The dry form of arthritis deformans, although specially common in the knee, is met with in other joints, either as a mon-articular or poly-articular disease; and it is also met with in the joints of the spine and of the fingers as well as in the temporo-mandibular joint.
Acromegaly is distinguished from osteitis deformans in that it is limited to hypertrophy of the hands, feet, and face, and it usually begins earlier. In gigantism the so-called "giant growth of bones" is often congenital in character, and is unaccompanied by inflammatory symptoms. The deformities of the articulations may be congenital but in most cases are acquired.
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