When the _joint is infected through an external wound_, the anatomical
features are similar to those observed when the infection has reached
the joint by the blood-stream, but the destructive changes tend to be
more severe and are more likely to result in disorganisation.
The _terminations_ vary with the gravity of the infection and with the
stage at which treatment is instituted. In the milder forms recovery is
the rule, with more or less complete restoration of function. In more
severe forms the joint may be permanently damaged as a result of fibrous
or bony ankylosis, or from displacement or dislocation. From changes in
the peri-articular structures there may be contracture in an undesirable
position, and in young subjects the growth of the limb may be interfered
with. The persistence of sinuses is usually due to disease in one or
other of the adjacent bones. In the most severe forms, and especially
when several joints are involved, death may result from toxaemia.
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