JOINT DISEASES ACCOMPANYING CERTAIN CONSTITUTIONAL CONDITIONS
#Gout.#--_Arthritis Urica._--One of the manifestations of gout is that
certain joints are liable to attacks of inflammation associated with the
deposit of a chalk-like material composed of sodium biurate, chiefly in
the matrix of the articular cartilage, it may be in streaks or patches
towards the central area of the joint, or throughout the entire extent
of the cartilage, which appears as if it had been painted over with
plaster of Paris. As a result of this uratic infiltration, the cartilage
loses its vitality and crumbles away, leading to the formation of what
are known as gouty ulcers, and these may extend through the cartilage
and invade the bone. The deposit of urates in the synovial membrane is
attended with effusion into the joint and the formation of adhesions,
while in the ligaments and peri-articular structures it leads to the
formation of scar tissue. The metatarso-phalangeal joint of the great
toe, on one or on both sides, is that most frequently affected. The
disease is met with in men after middle life, and while common enough in
England and Ireland, is almost unknown in hospital practice in Scotland.
|