Tuberculosis of Sacra-iliac Joint. 463 



7. 95. Tubercular Disease of the Knee-joint— Erasion.— 

 Suppurative Osteomyelitis of the Femur.— Section of 



the lower end of the femur and knee-joint of a child — in spirit, 

 illustrating the above. 



About two years before amputation, the child had suffered from 

 tubercular knee-joint disease, for which erasion had been performed. The 

 femur had afterwards been the seat of acute osteomyelitis, ending in 

 necrosis, for which amputation became necessary. 



The section shows a large sequestrum of the shaft of the 

 femur, surrounded by a very thick shell of new bone. The 

 epiphysis of the femur is seen beneath the patella. It is 

 separated from the shaft by a layer of fibrous tissue behind, 

 and by a large gap in front, which communicated with the 

 sequestrum. The original cavity of the knee-joint is now 

 occupied by fibrous tissue. G. C. 3458. 



Presented by John Duncan, F.R.C.S.E. 



Sacro-iliac joint. 

 7. 96. Tubercular and Septic Disease of the Sacro-iliac 



Joint. — Pelvis of an adult, macerated — showing extensive 

 destruction of the right sacro-iliac joint. 



The case is said to have been one of psoas abscess. 

 The sacrum and ilium in the neighbourhood of the joint 

 are much eroded, and very irregular. The acetabula are very 

 shallow, and all round the pelvis, but especially on the right 

 ilium, there are numerous irregular outgrowths of bone. 



W. C. H. 61. 



Hip- joint, 

 a. Changes primarily or chiefly in the synovial membrane. 



7. 97. Tubercular Synovitis.— A left hip-joint laid open — in 



spirit, illustrating the above. 



On the head of the femur shreddy granulations replace the 

 cartilage over the central portion, and at the margins. In 



