Tuhcrcular Ostitis involving Knee-joint. 451 



7. 65. Tubercular Arthritis beg-inning" in the Tibia.— 



Lower end of the left femur of a young adult, with the upper 

 ends of the tibia and fibula — macerated, showing changes 

 chiefly in the tibia. 



The upper end of the tibia is much lighter than normal. 

 In front its texture is opened out, and its shape is considerably 

 altered owing to rough excavations near the tubercle. The 

 cartilaginous surfaces are comparatively unchanged, although 

 the bone between them in front is rarefied. There has appar- 

 ently been a tubercular ostitis of the upper end of the tibia, 

 which would probably affect the synovial membrane. 



The cancellous tissue of the lower end of the femur has 

 been atrophied in the neighbourhood of the joint. 



r. P. C. 775. 



7. 66. Tubercular Arthritis begrinning" in the Head of 



the Tibia. ^Bones of a left knee-joint — macerated, illustrating 

 the above. 



A fragment of dead cancellous bone lies loose in a cavity 

 on the front of the inner tuberosity. This cavity communicates 

 above by a round hole with the front of the articular surface, 

 on the outer tuberosity. Some periosteal bone has been formed 

 round the upper end of the tibia, and the articular surfaces are 

 rarefied at the margins. The articular surfaces of the femur are 

 rarefied at various places, but there is little or no new bone 

 •formed on the condyles, F. P. C. 782. 



Presented by Professor John Thomson. 



7. 67. Tubercular Arthritis beg-inning- in the Head of 



the Tibia. — Right knee-joint, laid open from the front — in 

 spirit, illustrating the above. 



The patient was a man aged 28. The disease had existed for twelve 

 months, and was accompanied with much pain. "Bursa inflamed, 

 thickened, and suppurated, with abscesses in the vicinity of the joint. 



