432 Diseases of Joints. 



7. 17. Tubercular Synovitis. — Left knee-joint, opened from the 

 front — in spirit, illustrating the above. 



An encroachment of the diseased synovial membrane has 

 taken place upon the cartilage of the femur, especially opposite the 

 ligamentum mucosum and the ligamenta alaria, and round the 

 patella, whose cartilage is also at one place ulcerated through. 

 The interior of the synovial membrane has numerous delicate 

 fringed processes hanging from it. G. C. 541. 



7. 18. Tubercular Synovitis. — Right knee-joint, laid open from 

 the front- — in spirit, illustrating the above. 



There has been an encroachment of the diseased synovial 

 membrane upon the trochlear surface from above and laterally, 

 and also, as in the previous specimens, in the position of the 

 ligamentum mucosum and the ligamenta alaria. Similar to the 

 last also, but more advanced, is the affection round the patellar 

 cartilage. 



It should be remembered that what now appear to be 

 layers of lymph covering the cartilage have been in the recent 

 condition vascular granulations (see 7. 16 and the next 

 specimens). G. C. 2449. 



Presented by J. Bell Pettigbew, F.R.C.S.E. 



7. 19. Tubercular Synovitis. — Section of an injected knee-joint 

 — in spirit, illustrating the above. 



The patient, a lad of 15, had first felt pain in the joint in November 

 1886. This was followed b}^ a swelling, which began on the outside, and 

 spread all over the joint. An abscess was opened in March 1887, and 

 healed in four months, after which lie went about quite well, except that 

 a little swelling still remained. In March 1888 the disease again broke 

 out ; an abscess formed, and continued to discharge after having been 

 opened. The joint gradually grew worse, and the limb was amputated in 

 October 1888. At no time were there starting pains at night. The pain 

 was never great. The chief complaint was swelling and stiffness. 



The injected synovial membrane is seen encroaching on 



