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Clinicians studying Rheumatic Diseases have long used the surface temperature over the joints as indicative of the degree of synovial reaction. Many of the terms used in rheumatology imply temperature changes in the joint tissues, viz. "the acute hot joint of gout," "the cold swelling of chronic rheumatoid arthritis," the so-called "friction effect" or "heating-up" of osteoarthritic joints following exercise, or "articular jelling" (implying excessive joint cooling and stiffening on prolonged rest). Many measurements have been made of the skin temperature over diseased joints, but no study on intra-articular temperatures in human joints has been reported. Several studies (1-4) have been made of intra-articular temperatures in dogs and one study (5) was performed on the stifle joint of a horse to determine the coefficient of friction within the joint, with and without synovial fluid. METHODIn an effort to find a method for more accurate evaluation of activity of joint disease, and for determination of the effects of rest, exercise, physical therapy, drugs, and Roentgen rays on joints, the following technique for determining intra-articular temperature has been developed.Temperature studies were performed on the joints of normal volunteers and arthritic patients. All the studies were carried out in a room having a mean temperature of 24°C. The subjects were reclining quietly for at least one half hour prior to the studies. Because of the ease of approach, the.knee joint was the usual site of study. The skin was sterilized with an antiseptic (merthiolate) solution. The skin and joint capsule at a point one half inch medial to the medial border of the patella and high enough to avoid the fat pad was infiltrated with several cubic centimeters of 1% procaine solution. A 19 gauge needle was inserted through the synovial membrane into the joint space under the patella. Even in most normal joints, a few drops of fluid could be aspirated into a dry syringe. When it was certain that the point of the needle was under the patella and in the joint space, the 1 Aided by a grant from the National Foundation for Infantile Paralysis.syringe was removed and a fine copper constantan thermocouple or a thermistor was threaded through'the needle to a depth of several inches in order to project freely into the joint space. The needle then was either left in place or, more frequently, removed leaving the temperature-sensitive element in place. The emf developed by the thermocouples was measured by a Leeds and Northrup type K potentiometer, and the change in resistance of the thermistor was measured with a Wheatstone bridge. Thermocouples or thermistors were also fixed on the skin over-lying the patella, and in most cases a thermocouple was also placed on the skin of the opposite knee. Control temperature readings were taken after the joint had been at rest, with the element in place, for at least one half hour. If a therapeutic procedure was employed to modify joint temperature which would not permit leaving the metal thermocouple in pl...

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