Understanding Arthritis

The arthritides, known under one name or another since very early times, are still shrouded in confusion. If there seemed to be any progress in the understanding of the inflammatory diseases of joints, one might rest content in the assurance that with time there would come, naturally, a clarification of that most puzzling group of diseases. When, however, the subject seems to become more involved with each new contribution to the literature it may be advisable to look for the factors underlying this unfortunate situation. While on superficial study, the multiplicity of terms now used to denote the common forms of non-tuberculous arthritis, and the lack of agreement on classification, would seem to be the main causes for the present confusion, a deeper knowledge of the subject demonstrates that the causes are even more basic. While it is indeed true that even among the best informed, the refined anatomy and much of the more apparent physiology of the joints is a closed book, it is equally true that sufficient anatomy and physiology are known which, if applied to the diagnosis of joint affections, would permit a much better understanding of the disease processes. The average practitioner of medicine is unfamiliar with the anatomy and the physiology of the joints. It might be said further that the average student completing the first two years of his medical studies has a very inadequate conception of joint structures upon which to base a study of diagnosis. To be sure, the joints with their mechanism for the production of motion, are complicated structures and to expect medical students to have full knowledge of them at the midpoint of their studies may be an unreasonable requirement. It is, however, a prerequisite to the study of joint diagnosis that one have a general knowledge of the anatomy and physiology of the joint structures. In most medical school curricula even today, physical diagnosis of joint diseases is regarded as a part of the general course in