[Illustration: FIG. 160.--Arthritis Deformans of Hands, showing
symmetry of lesions, ulnar deviation of fingers, and nodular thickening
at inter-phalangeal joints.]
_The dry form of arthritis deformans_, although specially common in the
knee, is met with in other joints, either as a mon-articular or
poly-articular disease; and it is also met with in the joints of the
spine and of the fingers as well as in the temporo-mandibular joint. In
the joints of the fingers the disease is remarkably symmetrical, and
tends to assume a nodular type (Heberden's nodes) (Fig. 160); in younger
subjects it assumes a more painful and progressive fusiform type
(Fig. 161). In the larger joints the subjective symptoms usually precede
any palpable evidence of disease, the patient complaining of stiffness,
crackings, and aching, aggravated by changes in the weather. The
roughness due to fibrillation of the articular cartilages causes coarse
friction on moving the joint, or, in the knee, on moving the patella on
the condyles of the femur. It may be months or even years before the
lipping and other hypertrophic changes in the ends of the bones are
recognisable, and before the joint assumes the deformed features which
the name of the disease suggests.
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