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It varies as to intensity and the exact manner of its manifestation depends upon preëxisting disturbances. The same manifestation of pain is present when weight is supported by one foot, though in a lesser degree. There is less local heat to be detected by palpation than in the acute cases.
These affections are characterized by a fluctuating mass which has a thin wall and in all cases of long standing the condition is painless. By careful palpation one may readily distinguish between a hygromatous condition of the superficial bursa and involvement of the underlying structures.
On palpation, it is usually possible to displace the contents of the sheath from one compartment to the other, and this may yield fluctuation, and, what is more characteristic, a peculiar soft crepitant sensation from the movement of the melon-seed bodies.
The two conditions should not be confused, however, as the parts may be definitely outlined by palpation and the slack condition of the tendon and displaced summit of the calcaneum, which characterize fracture of the fibular tarsal bone, are easily recognized. Treatment.
There is pain in raising the heel from the ground, and creaking can be felt on palpation. The treatment consists in putting the affected tendon at rest, and with this object a splint may be helpful; the usual remedies for inflammation are indicated: Bier's hyperæmia, lead and opium fomentations, and ichthyol and glycerine.
Infectious arthritis of the scapulohumeral joint the result of local causes other than produced by septic wounds, seldom causes serious inconvenience to the subject. Where such occurs, however, there is manifested mixed lameness and complete extension of the extremity is impossible. Local swelling is present and manifestations of pain are evident upon palpation of the affected area. Treatment.
Where palpation of parts is possible, one does not need to depend on visual examination alone, and it is always wise to take into consideration every factor that may influence conditions. Manipulation or palpation of the structures thought to be involved, should not be resorted to until a careful and thorough observation of the subject has revealed all that it can reveal to the diagnostician.
Touch, in short, is an ambiguous term and includes both passive sensations and those forms of Activity which we describe when we use the term "feel" as a transitive verb. Just as we distinguish between seeing and looking or between hearing and listening, so should we distinguish between touch passive and touch active or palpation.
Blood extravasated deeply in the tissues gives rise to a firm, resistant, doughy swelling, in which there may be elicited on deep palpation a peculiar sensation, not unlike the crepitus of fracture. It frequently happens that, from the tearing of lymph vessels, serous fluid is extravasated, and a lymphatic or serous cyst may form.
In advanced cases, bead-like swellings are sometimes to be detected over the position of the valves, and, on running the fingers along the course of the vessel, a firm ridge, due to periphlebitis, may be detected on each side of the vein. When the limb is œdematous, the outline of the veins is obscured, but they can be identified on palpation as gutter-like tracks.
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