Experimental Studies on Visualization of Joints by Injections of a Drug.

Abstract

By the term arthritis the clinician usually means an inflammatory reaction involving the region of a joint. Such an inflammation may involve the synovial membrane alone, when it is termed more strictly synovitis. Usually, however, the inflammatory process involves the articular surfaces proper, their lining membranes, and the musculature and other soft tissues around the joints which are affected directly or indirectly by the patient's condition and play a rôle in the interference with free motion and production of pain and other symptoms. In order to institute rational treatment of a pathological joint condition, it is absolutely necessary to make a definite diagnosis and ascertain the exact condition of the tissues in the joint, or around it, which are involved, namely, whether the disease is confined to the bone itself, to the articular surfaces of the bones, or to the capsular or synovial membrane, and whether it involves the muscular tissue and has produced changes in the connective tissue, leading to adhesions. This is particularly true of the larger joints, and especially of the knee joint, which is the weakest mechanically and is subject to many diseases of acute and chronic nature leading to pathological changes. The most valuable help in the diagnosis of such pathological conditions is roentgenology, which gives a clue to the amount of involvement of bone tissue and the presence of osteophytic outgrowths in the vicinity of the joint. The x-rays, however, are not very helpful in establishing the amount of involvement of the soft tissues in arthritic conditions and, for this reason, any new method which may aid in this connection is welcomed by the orthopedic surgeon.

The author in 1914 reported experiments on the injection of phenosulphonphthalein into the joint cavity for the purposes of determining the absorptive power of the joint. 1