768 DISEASES OF THE SHOULDER-JOINT. 



Prognosis and course. The degree and extent of the injuries 

 associated with distortion being very varied prognosis is equally 

 uncertain. It must, therefore be principally guided by the degree 

 of lameness and the character of the local symptoms, as well as by 

 the time during which these have existed. If pain is slight, complete 

 recovery may occur in three to four weeks ; gradual improvement 

 during this time points to a favourable issue. On the other hand, 

 chronic arthritis may sometimes cause lasting and incurable 

 lameness. The more severe the lameness, and the longer it has 

 existed, the less favourable the prognosis ; marked atrophy of the 

 shoulder muscles is, therefore, an exceedingly grave symptom. 



Treatment. Complete rest must always be the first measure. 

 Cold applications, irrigation, or poulticing combat inflammation. 

 At a later stage irritants, blisters, and setons can be employed. The 

 subcutaneous injection of atropine and morphine has been 

 recommended by some but condemned by others. It might be 

 worth trying. 



(c) Wounding and Inflammation of the Shoulder-joint 

 (Omarthritis). — On account of its position, the shoulder-joint is 

 seldom wounded. Romant describes a torn wound of the joint in 

 a mule, in which perfect recovery followed the employment of 

 sublimate solutions. As a general rule, these injuries call for cautious 

 prognosis and treatment. 



Spontaneous inflammation of the shoulder- joint is seen in oxen 

 and dogs under the form of rheumatic arthritis ; in foals, calves, 

 and lambs, as a complication of so-called navel-ill. The shoulder- 

 joint is, however, not particularly prone to this disease. The knee 

 and hock are much more frequently attacked. Abscesses in the 

 neighbourhood of the joint seldom break into its cavity. 



Chronic omarthritis may either be a sequel of distortion and 

 luxation, or be of rheumatic origin. Williams gives two illustrations 

 of chronic omarthritis in horses, showing the edge of the joint covered 

 with oxostoses ; the synovial membrane was thickened, and to some 

 extent ossified ; in one case synostosis had occurred. 



Prognosis. The variations in the pathological conditions are so 

 great that no fixed principles can be laid down either for prognosis 

 or treatment. The degree of local change, the severity of the 

 lameness and the time it has existed, form the chief indications. 

 Excessive muscular atrophy and obstinate lameness are always grave. 

 The symptoms are equally varied (compare with kW Shoulder 

 Lameness "). 



