Osteo-arthropathy and its relationships : with abstracts of recorded cases, and a note by Dr. E. Legrain on cases observed in the Sahara : also a case of hyperplastic osteo-arthritis / by F.R. Walters.

  • Walters, F. Rufenacht (Frederick Rufenacht)
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Osteo-arthropathy and its relationships : with abstracts of recorded cases, and a note by Dr. E. Legrain on cases observed in the Sahara : also a case of hyperplastic osteo-arthritis / by F.R. Walters. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    2. Cases in which only the peculiar clubbed fingers have been noted. 3. A mixed group, including all those cases in which the enlargement of the extremities appears to have been primary, as well as others which are of uncertain nature, whether from insufficient details or for any other reason. A typical case would present the following features : 1. A history of previous thoracic disease. 2. A peculiar form of clubbing of the ends of fingers and toes. 3. Symmetrical bony enlargements, mainly affecting the articular ends of long bones. 4. Effusions and other changes in neighbouring joints, also roughly symmetrical. 5. Slight overgrowth of adjacent soft parts. 6. Other less constant or less frequently recorded fea- tures, dermal, neuro-muscular, vascular, urinary, &c. It will be necessary to consider some of these factors in detail. Changes in the finger ends.—1. Great enlargement of the terminal phalanx or soft parts covering it, both antero- posteriorly and laterally—“ drumstick fingers,”—in each of which the distal part becomes the biggest. 2. Hyperextension at the last joint. 3. A series of changes in the nail. This is (1) large and wide, overlapping its bed, and reaching to the lateral borders of the fingers ; (2) strongly curved in both directions and curving over the end of the finger, like a watch-glass or a parrot’s beak; (3) the root long and mobile, raised above the level of the second phalanx, so that it can be felt as a distinct ridge, and when pressed upon yields an elastic or semi-fluctuating sensation, or sometimes a more resistent sensation, while the centre of the nail feels firm and hard ; (4) the body of the nail often striated or furrowed in one or both directions ; (5) the colour bright pink, peach-coloured, or more or less cyanotic; (6) consistence diminished, so that it readily splits or breaks; (7) growth abnormally rapid. It will be noted that these characters are an exaggeration of those met with in lesser degrees in the ordinary clubbed