Enlargement of Bursa Patellcv. 547 



The chief swelling is over the lower end of the radius, but 

 there is also a smaller swelling over the head of the ulna. 



The main swelling is markedly lobulated, and at some 

 places rises into nobs. This was formerly described as a 

 diseased bursa, but the cast itself has the word " exostosis " 

 Avritten upon it. Probably, however, it was a ganglion, associ- 

 ated with arthritis deformans, and so tense that it felt like 

 bone. F. P. C. 293.3. 



Burs.t:. 



{Injuries.) 



Diseases. 



I. Aexormalities IX Growth and Development. 



II. Changes pkoduced by Alterations in Nutrition and Growth. 



9. 13. Great Enlargement and Distension of the Bursa 



PatellSB. — A large sac, with a portion of the skin and under- 

 lying soft parts, dissected from the front and outer side of a 

 knee — in spirit. 



The patient, a woman aged 50, had been aware of the swelling for 

 nineteen years. 



The main sac is lined by a somewhat flocculent membrane. 

 Behind the sac there was a considerable thickening, composed 

 of fibrous tissue, enclosing soft, friable material. 



This is a form of chronic enlargement of the bursa, the 

 nature of which is obscure. G. C. 2751. 



Presented by A. G. Miller, F.R.C.S.E., 1885. 



9. 14. Great Enlargement and Distension of the Bursa 



PatellaB. — Plaster of Paris cast of the previous specimen. 

 Its circumference before removal was 16i inches. 

 The cast shows the lobulated character of the growth, and 

 its prominence on the front and outer side of the joint. 



G. C. 2751a. 

 Pmc?i!!et£ &^ A. G. Miller, F.R.C.S.E., 1885. 



