Vietnam or Thailand ? Vote for the TOP Country of the Week !
Updated: May 4, 2025
"Crescit indulgens sibi dirus hydrops Nec sitim pellit."
This form of the disease is extremely chronic, and may last for an indefinite number of years. It is to be diagnosed from the other forms of hydrops already considered the purely traumatic, the pyogenic, gonorrhœal, tuberculous, and syphilitic and from that associated with Charcot's disease.
Hydrops is most marked in the knee, and may affect also the adjacent bursæ. As the joint becomes distended with fluid, the ligaments are stretched, the limb becomes weak and unstable, and the patient complains of a feeling of weight, of insecurity, and of tiredness. Pain is occasional and evanescent, and is usually the result of some extra exertion, or exposure to cold and wet.
The secondary changes in joints which are the seat of paralytic contracture are considered with the surgery of the Extremities. In cases of hysteria and other functional affections of the nervous system, an intermittent neuropathic hydrops has been observed especially in the knee.
While they may result from the coagulation of fibrin-forming elements in the exudate, their occurrence in tuberculous hydrops would appear to be the result of coagulation necrosis, or of fibrinous degeneration of the surface layer of the diseased synovial membrane. However formed, their shape is the result of mechanical influences, and especially of the movement of the joint.
It may be months or even years before the lipping and other hypertrophic changes in the ends of the bones are recognisable, and before the joint assumes the deformed features which the name of the disease suggests. The capsular ligament, except in hydrops, is the seat of connective-tissue overgrowth, and tends to become contracted and rigid.
In the Bones, lesions occur which assume the clinical features of an evanescent periostitis, the patient complaining of nocturnal pains over the frontal bone, sternum, tibiæ, and ulnæ, and localised tenderness on tapping over these bones. In the Joints, a serous synovitis or hydrops may occur, chiefly in the knee, on one or on both sides.
In recent cases the symptoms subside under rest and the application of fomentations. Hydrops may be got rid of by blistering, by tapping, or by incision and drainage. When the wall is thickened, the most satisfactory treatment is to excise the bursa; the overlying skin being reflected in the shape of a horse-shoe flap or being removed along with the bursa.
The limb may be disabled from involvement of the adjacent joint, in which there may be an intermittent hydrops which comes and goes coincidently with exacerbations of pain; or the abscess may perforate the joint and set up an acute arthritis.
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.
Word Of The Day
Others Looking