Tubercular Arthritis siibsiding. 455 



7.75. Tubercular Arthritis, with great Loss of Bone, 



subsiding". — Bones forming the left knee-joint of an adult 

 — macerated, illustrating the above. 



In the femur a portion of the articular surface below each 

 condyle exactly fits the articular surfaces on the tibia, and 

 is comparatively unchanged. In front of this the arti- 

 cular surface on each condyle is deficient, and on the outside 

 it is deeply eroded. Above the articular surface there is a 

 circular aperture about an inch in diameter, leading to a large 

 cavity within the bone, opening posteriorly. A thin crust of 

 new periosteal bone has been formed on the surface for three 

 or four inches above the lower end. 



On the outer tuberosity of the tibia the articular surface 

 is unusually concave, and projects above the surrounding bone, 

 .but it is not eroded. The articular surface on the inner 

 tuberosity is of a similar shape, but in addition both it and 

 the surrounding bone have been eroded and excavated by 

 tubercular granulations. There is also a roughening by 

 periosteal deposit of the sides of the inner tuberosity. This 

 has been a case where the interior of the lower end of the 

 femur has been greatly affected although there has also been 

 anchylosis of the joint in the straight position. G. C. 374. 



7. 76. Tubercular Synovitis tending- to Anchylosis.— 



Knee-joint laid open from the front, apparently by forcible 

 flexion — in spirit, illustrating the above. 



The articular surfaces of the femur and tibia have been 

 partially anchylosed by developing granulations, while the 

 patella has been drawn right up. The skin over the front of 

 the knee is extensively cicatrised. 



This was entered in the MS. Catalogue as a "scrofulous 

 knee-joint." It may, however, have been a case of excision, 

 followed by amputation. G. C. 2451. 



7. 77. Tubercular (?) Arthritis, partially cured, but with 



