INFLAMMATION. This disease is most frequently caused by tuberculosis, although it may be due also to other causes, such as infectious diseases (scarlatina, typhoid fever, gonorrhoea), or purulent inflammation of the marrow in the thigh-bone (osteontalacia). The affection is observed more often in children than in adults, and is popularly known as " voluntary limping." The first symptoms of the disease are disturbances of the motility of the joint and pain in the knee. It is often the case that children with beginning inflammation of the hip-joint complain only of the pain in the knee, so that parents believe an inflammation of the knee-joint is present. Sometimes there may be only a slight stiffness at the hip-joint. • If the disease progresses, the joint often becomes entirely immovable, and the affected leg appears at first too long, then too short. This alternating elongation and shortening of the leg is, however, apparent only. A true shortening of the leg cannot occur until a later stage of the disease is reached, when the head and neck of the femur become destroyed. Often so-called
cold abscesses develop. These may be located either on the front part of the leg or behind the hip-joint ; sometimes they may occur also in the pelvis.
Hip-joint inflammation is a very protracted disease, which in some instances may cause death by the extension of the inflammation or by the spreading of the tuberculous process to internal organs. Even in cases of recovery there usually remains defective motility of the hip-joint or even lasting stiffness and limping.
The more careful the treatment the better the final result. Treatment consists in straightening the limb with an extension-apparatus or with plaster-of-Paris bandages. Abscesses must be opened. Severe destruction of the joint necessitates the removal of the diseased bones and the joint capsule. A careful diet is of immense service in this disease. Open air living is equally essential.