448 Diseases of Joints. 



strength was much reduced, and the operation was resorted to as the only 

 means of saving his life. He, however, died some days after the removal 

 of the limb, in which no healing process ever took place. . . . The joint 

 after removal showed incurable disease, viz., deep-seated abscesses filled 

 with scrofulous-looking matter occupying the bone and extending a 

 considerable way down the leg. The articular cartilages covering the 

 cond}' les of the femur, tlie patella, and surface of the tibia were almost 

 entirely destroyed. Finally, the bones were deeply affected with caries, 

 the tibia to a great extent." 



Besides a general rarefaction of the articular surfaces, the 

 specimen shows deep erosions similar to those in former 

 specimens, on the outer articular surface of the tibia, and on 

 the outer condyle of the femur, (In the recent state such 

 erosions are occupied by tubercular caseous granulations with or 

 without fragments of necrotic bone.) Towards the back of 

 the outer condyle of the femur there is a small patch of smooth 

 bone surrounded by a trench in the bone texture, and beyond 

 that by the general surface of rarefied cancellous bone. 



This is a necrosed fragment in process of separation, like 

 that seen in 7. 34. It is to be noted that, as in several previous 

 specimens, there is very little new periosteal formation round 

 the articular surfaces. The Avhole of the bones are lightened. 



G. C. 864. 



Presented hy Sir George Ballixgall, .30th October 1836. 



7. 57. Necrosis of Apticular Surfaces from Tubercular 



Synovitis (?). — Bones forming the right knee-joint of an adult 

 — in spirit, showing extensive changes in the bone. 



There is a large loose fragment on the inner condyle of 

 the femur, and on the outer condyle there is a smooth patch, 

 partially entrenched round. On the tibia there is a deep hollow 

 on the inner articular surface, which formerly contained a 

 necrosis, while the greater part of the outer articular surface 

 is smooth and entrenched round like the patch on the femur. 

 A portion of the trochlear surface of the femur is found to 

 be still covered with cartilage. The remainder of the articular 



