970 CHRONIC INFLAMMATION OF THE STIFLE-JOINT. 



or other counter-irritants can be tried. Recovery is extremely 

 rare, and the improvement of reported cases probably depends on 

 mistakes in diagnosis. 



A twelve- year- old gelding in heavy draught had for two years shown 

 slight lameness in each hind limb alternately. The limbs gradually became 

 upright, the movement stiffer, and the quarters more markedly sloping. In 

 both limbs, the capsular ligament of the stifle-joint was prominent, being 

 best defined below the patella (Fig. 527). When resting, the hind legs 

 were lifted alternately and strongly Hexed at short intervals ; the horse 

 had not lain down for a long time. In work, the hind limbs were carried 

 stiffly and the stride shortened. The animal had become so useless that 

 its owner caused it to be slaughtered. 



The post-mortem examination showed marked proliferation of connective 

 tissue in the muscles of the quarter and thigh, the new growth appearing 

 in the perimysium externum in the form of broad white bands (myositis 

 chronica fibrosa). There was chronic inflammation in the gluteus medius 

 bursa, with great increase in the villi, which were 1 to 1J inch in length and 

 | to I of an inch thick. 



The patellar joint was full of a yellow viscous fluid. The capsular 

 ligament was distended, and the synovial membrane covered with long 

 Villous growths. In the true stifle-joint the articular cartilage had almost 

 disappeared from the internal division, and scarcely a trace remained on 

 the spine of the tibia, though numerous eburnated porcellaneous deposits 

 were visible." The margins of the internal division of the joint, particularly 

 the tibial margin, were prominent and thickened. The patellar joint 

 exhibited no particular change. 



VII.— BURSITIS PR^PATELLARIS. 



The bursa praepatellaris according to Eichbaum, occurs in fully 

 half of all horses. It lies on the anterior surface of the patella, and 

 when injured is apt to become inflamed ; the swelling, which is 

 sometimes fluctuating, sometimes moderately firm, attaining the size 

 of two fists. It seldom produces pain or lameness, and only forms 

 a blemish like " capped elbow." 



The disease being caused by bruises or other injuries, is sometimes 

 accompanied by inflammatory symptoms, but sometimes occurs 

 without them. Lameness is absent in the latter case, a fact to be 

 remembered in diagnosing other diseased conditions. Should treat- 

 ment be considered necessary, fluctuating swellings (hygromata 

 of the bursa) may repeatedly be punctured with the hollow needle, 

 or with a slender trocar, and emptied. Injection of iodine may also 

 be tried. As in " capped elbow," free incision leads to long-continued 

 suppuration, and is therefore not advisable, unless the bursa can 

 be destroyed by cautery or caustic. Blisters and firing may produce 

 gradual contraction, but require repeated application. Care must 



