316 Anatomy Applied to Medicine and Surgery. 



te'rior crural. Movement. Every movement, viz., flexion, 

 extension, rotation, abduction, adduction and circumduc- 

 tion, with their combinations, is permitted at this joint. 



Synovitis. In this disease the position assumed by 

 the limb is that of flexion, eversion and abduction. Treves 

 shows, that it is in this position, that the joint contains the 

 greatest amount of fluid, and, therefore, when the synovial 

 sac is distended with hypersecretion, as in synovitis, the 

 limb is flexed, abducted and rotated outwards, so as to dis- 

 tribute the pressure, as evenly as possible, on the inflamed 

 synovial membrane. It is flexed to relax the main por- 

 tion of the ilio- femoral ligament, abducted to further relax 

 the outer arm and everted to further lessen the pressure 

 due to the inner arm of this ligament. In synovitis the 

 swelling is rarely appreciable because of the deep situa- 

 tion of the joint, but when it is, its usual situation is be- 

 hind the great trochanter, or in front, below the middle of 

 the line separating the thigh from the abdomen ; or it may 

 be internally, in the angle between the thigh and perineum, 

 behind the adductor longus tendon. It must not be for- 

 gotten that there are three burst? in the neighborhood of 

 the joint, which, when distended, might, if not carefully 

 examined, lead one astray in the diagnosis of synovitis 

 with effusion one, beneath the ilio-psoas muscle between 

 it and the capsule of the joint, and extending as far as the 

 lesser trochanter ; a second, over the great trochanter, be- 

 tween it and the gluteus maximus, and a third over the 

 ischial tuberosity. The diagnosis may be assisted by the 

 fact, that, when either of these bursae is distended, there is 

 neither swelling nor fluctuation present at the other points 

 mentioned above as the possible seats of the swelling in 

 synovitis of the hip joint. 



Morbus Coxae or Tuberculosis of the Hip Joint. 

 In the young, tuberculosis of the hip may start in the base 

 of the acetabulum, or in the femur, either in the head under 



