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By James E. Moore, M.D.,: Minneapolis
By James E. Moore, M.D.,: Minneapolis
OF THE
By JAMES
WRIST
E. MOORE,
AND
CARPUS.
M.D.,
MINNEAPOLIS.
Tiirs subject was chosen because it has not been before this Asso
ciation for discussion yet, and because the writer hopes to bring out
the experience of those present in the discussion.
As compared with other joints, this is a rare seat of disease, and
one man's experience is necessarily limited.
Of 919 cases of tuber
cular arthritis collected by Cheyne, only six were of the wrist and
hands.
Most writers state that wrist-joint disease constitutes from
4 to 5 per cent. of all cases of joint disease.
A peculiarity of this disease is that it occurs most frequently be
tween the ages of fifty and sixty.
Chieyne says that he believes the
synovial type prevails here, but says that it is difficult to prove.
Senn says that the synovial type is most common.
Every case
operated upon by the writer has been of bony origin.
The radius
is the most frequent seat of disease, and the proximal ends of the
metacarpal bone next.
The causes of tuberculosis here are the same as in other joints,
save that in a majority of cases of tuberculosis of the wrist it begins
in matured tissues instead of growing tissues.
It would also seem
that tuberculosis of the wrist is more closely connected with a gen
eral tubercular condition than the same disease in other joints.
Although this joint is so situated that it is very sub,ject to trau
matism, this disease is rarely the result of an injury.
The only
case under the writer's care due to an injury was one in which the
patient was already suffering from a tubercular empyema, and who
finally died from pulmonary tuberculosis.
The pathology of tuberculosis of the wrist and carpus does not
differ in any way from the same disease in other joints. The sheaths
JAMES
E.
MOORE.
101
102
TUBERCULOSIS
OF THE WRIST
AND CARPUS
JAMES
E. MOORE.
103
104
TUBERCULOSIS
OF THE
WRIST
AND CARPUS.
DISCUSSION.
DR. MCKENZIE
said that
he had
seen
in a man, thirty-three
years of age.
disease
DISCUSSION.
105
surprised
remarks
that he
ments made regarding the amount of pain from this condition, for
he had been under the impression that there was but little pain as
sociated with wrist-joint disease.
DR. MOORE, in closing
the discussion,
said
that
he had
simply