Local Characters of Joint Swellings
In early stages the skin over the joint is waxy white or semi-asphyxial in tint, outline of joint smooth, rounded, and spindle in shape, with, as a rule, no irregular bony projection at the level of the articulation. If seen at a later stage, the swollen joint will be found shrunken from atrophy of all the articular structures as well as the skin. Ultimately it becomes reduced even below its normal size, the small “end-joint” of atrophic or rheumatoid arthritis. The deformities due to muscular spasm are usually in the direction of luxation and hyperextension, and differ from those of gout and osteoarthritis, in which there is more generally lateral displacement.