Arthropathy and Inflammatory Reaction in Hemiplegic Patients

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Abstract
Four cases of hemiplegia with arthropathy in the side involved resembling a mild RA are reported. Tissue clearance of phenolsulfophthalein (PSP) from the skin of the forearm in the side involved was significantly poor as compared with the other side in 55 hemiplegic patients. Inflammatory reaction induced by tuberculin on the forearm skin of 34 hemiplegic patients showed great difference in both sides. Erythema was larger in the side not involved, while swelling was thicker and induration was more intense in the side involved. These changes concerning the inflammatory reactivity in the paralytic extremity appeared to have some connection with poor tissue clearance. These studies indicate that inflammatory reactivity of the paralytic extremity differs from that of the extremity not involved in hemiplegic patients and that inflammation is largely influenced in some cases by the nervous and circulatory systems. Modifications of arthropathy and arthritis in hemiplegic patients may be explained partly by the disuse of the paralytic extremity and partly by the changes in inflammatory reactivity which are discussed.