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joints, affected, fingers and disease

ARTHRITIS DEFORMANS.óDeforming inflammation of the joints. It is still an open question whether this affection is an individual disease, or whether it is a variety of chronic articular rheumatism. It is distinguished from the latter in that the affected joints, as is implied by the name, are " deformed," considerable growths of the bones changing the form of the joints. The deformity is still more intensified in that the muscles surround ing the joint become thinner and gradually waste from disuse. Otherwise the symptoms of the disease are almost the same (pain and stiffness of the joints) as in articular rheumatism, which may persist for years. The affec tion occurs most frequently in middle-aged and elderly persons, but it has also been observed in young people and in children. It has no connection whatever with gout. Women are more frequently affected than men.

The disease begins with pains in the joints, occurring principally during exercise, and subsiding during rest, and with disagreeable stiffness of the joints, most marked after rest (for instance, after rising in the morning). These disturbances are soon followed by a continually increasing restric tion of movability, and by a visible alteration of the affected joints. The disease involves either one joint only (for instance, the hip-joint) or, as is usually the case, several joints (those of the fingers, hands, vertebrx, etc.).

The disease operates in such a manner that the corresponding joints of both halves of the body become affected, although usually the joints of one side are more markedly affected than those of the other. The joints of the fingers are most frequently attacked, resulting in a peculiar attitude of the hand. The fingers are slightly curved, held obliquely toward the side of the little finger, and imbricated ; the joints between the fingers and the bones of the middle hand are swollen and thickened (see Fig. 74). As the thumb remains fairly movable, a great many patients are still able, in spite of the stiffness of the fingers, to accomplish finer work with their hands (for instance, writing and needlework). Similar, but not quite as marked, are the changes in other parts of the body. Other morbid disturbances, apart from wasting of the muscles, are not observed.

Although the affection persists for a long time, the patient should not become despondent. There occur cessations, even improvements, and it is possible, with proper treatment and good care, to render life endurable even in severe cases, and often to achieve satisfactory results. The treat ment is, upon the whole, the same as that of chronic articular RHEUMA TISM (which see).