Quotation from: Manual of SurgeryWritten by: Alexander Miles and Alexis Thomson |
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The _clinical features_ are characteristic. There is a sudden onset of excruciating pain, usually during the early hours of the morning, the joint becomes swollen, red, and glistening, with engorgement of the veins and some fever and disturbance of health and temper. In the course of a week or ten days there is a gradual return to the normal. Such attacks may recur only once a year or they may be more frequent; the successive attacks tend to become less acute but last longer, and the local phenomena persist, the joint remaining permanently swollen and stiff. Masses of chalk form in and around the joint, and those in the subcutaneous tissue may break through the skin, forming indolent ulcers with exposure of the chalky masses (_tophi_). The hands may become seriously crippled, especially when the tendon sheaths and bursae also are affected; the crippling resembles that resulting from arthritis deformans but it differs in not being symmetrical.
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