478 Diseases of Joints. 



On the front of the humerus, the two small portions of 

 necrotic bone are seen, partially separated by the surrounding 

 granulations. G. C. 3237. 



Presented by J. M. Cotterill, F.R.C.S.E. 



7. 136. Tubercular Synovitis, involving- the Bone. — Lower 

 end of a left humerus — macerated, illustrating the above. 



The articular surface is rarefied and much wasted, and 

 shows an excavation on the outer side. Some new bone has 

 been thrown out on the condyles. B. C. ii. M. 54. 



7. 137. Tubercular Synovitis, involving- chiefly the Radius 



and Ulna. — Adjacent halves of a left humerus, radius, and 

 ulna — macerated, illustrating the above. 



The disease was of many years standing, and the limb was am- 

 putated by Professor Ballingall by the double flap method. The patient 

 was dismissed within a fortnight, with the wound healed by first 

 intention. 



The articular surface of the humerus is rarefied and eroded 

 at places. The articular surface of the ulna is rarefied and 

 irregular, being excavated in many places. The changes, how- 

 ever, are most advanced in the radius. The interior of the 

 head of that bone is for the most part absorbed. The upper 

 articular surface has necrosed, and, although still in position, is 

 separate from the surrounding bone. 



These changes seem to be advanced stages of those seen in 

 previous specimens. G. C. 905. 



b. Changes primarily or chiefly in the Bone. 



7. 138. Senile Tuberculosis affecting- the Bones of the 



Elbow. — Section of the right elbow of an old man — injected, 

 and in spirit, illustrating the above. 



The patient, although aged 81, was wiry and strong. His family 



