Osteoarthropathy

OSTEOARTHROPATHY (from Greek osteon—bone, arthron—joint, and pathos—suffering), a lesion of a joint that involves, to a greater or lesser extent, the articular ends of the corresponding bones. Although among processes of this kind only a few have a primarily inflammatory character, they are nevertheless often grouped together under the name osteo-arthritis. This name, which is rightfully applicable strictly only to the following forms: 1) to purulent osteo-arthritis, rarely developing either on the basis of severe purulent joint lesions (with purulent melting of the cartilage and the spread of inflammation to the underlying bone tissue) or on the basis of severe purulent epiphyseal osteomyelitis (in the case of pus breaking through the articular cartilage into the joint cavity), and 2) to various specific osteo-arthritides (tuberculous, syphilitic, leprous, etc.). Among the latter, tuberculous ones are encountered more frequently and arise via the same two pathways as purulent ones, but mainly from tuberculous foci in the corresponding articular ends of the bone (the so-called bone form of articular tuberculosis); syphilitic ones are observed significantly less frequently (specifically in the gummatous period of the disease), with the course of the process here being the same as in tuberculosis (i.e., mainly this is the bone form of syphilis of the joints). (For leprous osteo-arthritis, see Leprosy.) Among non-inflammatory lesions of this kind, at the basis of which lie, for the most part, primary degenerative-atrophic or necrotic processes in the articular cartilage and underlying bone, the greatest significance in terms of frequency belongs to osteoarthritis, s. osteo-arthropathia chronica deformans with its subspecies (see Arthritis—Deforming Arthritis) and neuropathic osteoarthropathies, encountered in tabes dorsalis and syringomyelia. Furthermore, spondyloarthritis ankylopoetica and osteoarthropathie hypertrophiante pneumique (see Marie's disease), gouty osteoarthropathies (see Gout), and finally all those osteo-articular lesions, the most typical example of which can serve as Perthes' disease (see Osteochondritis, Perthes' disease), and which are grouped by Axhausen on the basis of the localization of primary changes under the name of the "bone form" of deforming arthritis, in contrast to its usual "cartilaginous" form, must be attributed to this same group.