Fig. 103.—Arthropathy of Shoulder in Syringomyelia. The upper end of the humerus has disappeared and the movements are flail-like (cf. [Fig. 104]).
Fig. 104.—Radiogram of specimen of Arthropathy of Shoulder in Syringomyelia. The head of the humerus has disappeared and masses of new bone have formed in the surrounding muscles (cf. [Fig. 103]).
Loose bodies are rare in the shoulder; we have met with a case in which the joint-cavity was distended with loose bodies of synovial origin, and as most of these had undergone ossification, the X-ray appearances were highly characteristic. They were removed through an anterior incision.
Ankylosis is not so disabling at the shoulder as at other joints, as the mobility of the scapula on the chest wall largely compensates for the fixation of the joint.
The Elbow-joint
In disease of the elbow, the usual attitude is that of flexion with pronation of the hand. Swelling of the joint, whether from effusion of fluid or from thickening of the synovial membrane, is observed chiefly on the posterior aspect, above and on either side of the olecranon, because the synovial sac is here nearest the surface. The free communication between the elbow and the superior radio-ulnar joint should be borne in mind.