T'uhercular Synovitis of Knee-joint, 443 



condyle there is a piece of the smooth necrotic bone so often 

 seen in advanced cases of tubercular arthritis. G. C. 1231. 

 Presented by Sir George Ballingall. 



7. 40. Tubercular Synovitis involving* the Bone.— Cast in 



glue and glycerine of a knee-joint laid open after amputation 

 for the above. 



The patient, a boy T.M., aged 14, had been troubled for three years 

 .before admission to the Royal Infirmary, Edinburgh, with his knee. For 

 the last two years there had been swelling, but very little pain. When 

 admitted, seven weeks before the amputation, the joint was uniformly 

 enlarged with a large peri-articular abscess on the inner side. For a time 

 after this abscess was opened, the patient did well, but the wound became 

 septic. The temperature then rose to 103" F. and kept there. Intense 

 pain accompanied any attempt at movement, and there were starting 

 pains at night. Hematuria set in. Before the amputation these 

 symptoms had somewhat subsided under free drainage, and daily syringing 

 out the knee-joint with 1"1000 corrosive sublimate lotion. 



When laid open after the amputation the joint was found 

 to contain pus. The articular surfaces were eroded, leaving the 

 bone bare, but not soft. At places numerous necrosed fragments 

 lay loose on the surface of the bone, and a cavity existed in the 

 head of the tibia. 



The cast shows the narrow rim of cartilage which was left 

 in the femur and the patella, and the irregularity of the rest of 

 the surface covered by granulations. G. C. 2801. 



Frescntcd by Charles AV. Cathcart, F.R.C.S.E. 



7.41. Tubercular Synovitis involving" the Bone— Section* 



in spirit of parts of the knee of which the foregoing specimen 

 is a cast. 



The now shrivelled and blanched (by the spirit) granula- 

 tions on the end of the femur are well seen, also erosions by 

 granulation tissue into the head and shaft of the tibia. An 

 external opening into a large posterior abscess is indicated by a 



