Tuhercular Ostitis involving Ankle-joint. 469 



— Section of the left foot of a woman — in spirit, illustrating 

 the above. 



The patient, aged 43, was delicate and nervous, and had previously 

 suffered from suppurating cervical glands. A tubercular abscess had 

 formed in the lower end of the tibia (No. 6. 212), which was opened and 

 scraped. Fourteen days afterwards the pain settled in the ankle, and 

 amputation became necessary. 



The specimen shows tubercular affection of the synovial 

 membrane, extending over the upper surface of the astragalus 

 and attacking the cartilage. 



Although the disease in this case was primarily in the 

 bone, this specimen has been placed among the synovial 

 membrane affections, because it shows the disease there only. 



G. C. 2836. 

 Presented by Charles W. Cathcaiit, F.R.C.S.E. 



7. 111. Tubercular Synovitis involving Cartilagre and 



Bone. — Bones forming a right ankle-joint " from a negro boy " 

 — injected with vermilion, and in spirit. 



The joint is exposed from the front by a section of the 

 tibia, which is turned down. 



The articular surfaces of the ankle-joint, and especially 

 those of the astragalus, are covered with a flocculent vascular 

 membrane, to which the sound cartilage on the under surface 

 of the astragalus forms a striking contrast. There is a cavity 

 in the inner side of the tibia above the malleolus, which is 

 lined by vascular granulations. 



A portion of the skin below this has been left to show 

 sinuses which must have opened into the joint, and by which 

 no doubt, sepsis had entered to complicate the tuberculosis. 



B. C. II. M. 35. 



7. 112. Tubercular Synovitis, involving- the Articular 

 Surface of the Tibia. — Lower end of a left tibia — macerated, 

 illustrating the above. 



