penetrant wounds. Sharp shoe-calks afford a means of infliction of
penetrant wounds which may occasion open joint and infectious arthritis.

Classification.--A practical manner of classifying inflammation of the
elbow is on an etiological basis. Eliminating the forms of elbow
inflammation, such as are caused by metastatic infection and other
conditions which properly belong to the domain of theory of practice, we
may consider this affection under the classification of _contusive
wounds_ and _penetrative wounds_.

Symptomatology.--Any injury which is of sufficient violence to
occasion inflammation of the elbow causes marked lameness and
manifestation of pain. The degree of lameness and distress manifested by
the subject, depends upon the nature and extent of the involvement. A
contusion suffered as the result of a fall, which occasions a
circumscribed inflammation of the structures covering this joint and
where little inflammation of the articulating parts exists, marked
evidence of pain and lameness might be absent. On the other hand, if a
true arthritis is incited, there will be evident distress manifested,
such as hurried respiration, accelerated pulse, inappetence, mixed
lameness, local evidence of inflammation and particularly marked
supersensitiveness of the affected parts. Considering these two extremes
of manifested distress and injury, one may readily conclude that in the
frequently seen case, wherein contusion has occasioned a moderate
degree of injury, prognosis is favorable and recovery ordinarily
follows in the course of a few weeks' treatment.

In cases of arthritis due to penetrative wounds (because of the
important function of this joint and its large capsule, which when
inflamed discharges synovia in a manner that closure of such an open