Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


_Impairment of the normal movements_ is one of the most valuable
diagnostic signs, particularly in deeply seated joints such as the
shoulder, hip, and spine. It is due to a protective contraction of the
muscles around the joint, designed to prevent movement. This muscular
fixation disappears under anaesthesia.


_Abnormal attitudes of the limb_ occur earlier, and are more pronounced
in cases in which pain and other irritative symptoms of articular
disease are well marked, and are best illustrated by the attitudes
assumed in disease of the hip. They are due to reflex or involuntary
contraction of the muscles acting on the joint, with the object of
placing it in the attitude of greatest ease; they also disappear under
anaesthesia. With the lapse of time they not only become exaggerated, but
may become permanent from ankylosis or from contracture of the soft
parts round the joint.

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