968 CHRONIC INFLAMMATION OF THE STIFLE-JOINT. 



VI.— CHRONIC INFLAMMATION OF THE STIFLE-JOINT. 



Chronic inflammation of the stifle-joint usually involves the 

 femoral condyles, inter-articular fibro-cartilages, and tibial facets, 

 and principally occurs in heavy draught horses. Occasionally, and 

 generally in horses that work continuously at a sharp trot, the 

 disease affects the femoro-patellar articular surfaces. Chronic gonitis 

 of the femoro-tibial joints is also seen in dogs, particularly in the 

 larger coursing and working breeds. In dogs, the disease is generally 

 unilateral ; in horses it sometimes affects both stifles. Holme regards 

 it as a common cause of lameness in horses, and thinks it is often 

 mistaken for developing spavin, but the symptoms differ considerably, 

 and should not be confused if care be taken in diagnosis. In femoro- 

 tibial disease post-mortem examination discovers changes similar 

 to those of arthritis chronica sicca vel deformans : erosions or 

 excavations of the condyles and tibial facets, with more or less de- 

 struction of the inter-articular fibro-cartilages and thickening of the 

 synovial membranes. Erosion of the articular surfaces is most 

 marked around the tibial spine and at the inferior surface of the 

 condyles ; osteophytes occur, and there is sometimes moderate dropsy 

 of the joint. As a rule, the inner division of the joint undergoes 

 more destruction than the outer, which sometimes remains intact 

 or little altered. 



In femoro-patellar disease similar changes occur in the articular 

 surfaces. In addition to thickening of the intra-articular ligaments 

 and cauliflower growths on the articular surface of the femur, Holme 

 found eburnated elevations and depressions in the spongy tissue 

 of the ends of the bones, and enlargement of the inner condyle to 

 the extent of three-eighths of an inch. Sometimes he could only detect 

 condensation of the spongy tissue of the inner condyle. It is, there- 

 fore, not absolutely certain that Holme was always dealing with the 

 disease now in question. 



Symptoms and course. Femoro-tibial disease develops slowly 

 and very gradually, but eventually proves so troublesome that the 

 animal has to be destroyed. Sometimes it persists for months, 

 or even years. At the outset, the lameness is slight or intermittent, 

 and where the disease is bilateral may for a long time be overlooked. 

 In the stable at first, the diseased limb is knuckled at the fetlock ; 

 when both limbs are affected, they are rested alternately ; later, 

 the limb is semi-flexed and the foot is held raised from the ground 

 (Fig. 526). In turning, the affected limb may be lifted spasmodi- 

 cally, as in spavin and stringhalt. When commencing to walk, 



