Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


_Syphilitic osteo-arthritis_ results from a gumma in the periosteum or
marrow of one of the adjacent bones. There is gradual enlargement of one
of the bones, the patient complains of pains, which are worst at night.
The disease may extend to the synovial membrane and be attended with
effusion into the joint, or it may erupt on the periosteal surface and
invade the skin, forming one or more sinuses. The further progress is
complicated by the occurrence of pyogenic infection leading to necrosis
of bone, in the knee-joint, for example, the patella or one of the
condyles of the femur or tibia, may furnish a sequestrum. In such cases,
anti-syphilitic treatment must be supplemented by operation for the
removal of the diseased tissues. In the knee, excision is rarely
necessary; but in the elbow it may be called for to obtain a movable
joint.

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