The Region of the Knee Joint. 355 



of the latter prominences is as follows : The outer tuber- 

 osity is about three-quarters of an inch above the line of 

 joint ; the anterior portion of the upper border of the fibular 

 head is three-quarters of an inch belowthe line of the joint, 

 whereas, the styloid process of the fibula is a little less than 

 half an inch below the joint line. The epiphyseal line 

 for the lower end of the femur runs transversely outwards 

 from the adductor tubercle on the upper part of the inter- 

 nal condyle, and skirts the upper border of the articular 

 surface ; that for the tibia, runs towards the middle line of 

 the bone immediately below the tibial tuberosities and in- 

 cludes, therefore, the articular facet of the tibia. As 

 these lines approach the middle of the bone, they descend 

 and meet at the lower border of the tubercle of the tibia, so 

 as to include it in the epiphysis. Behind the upper third of 

 the ligamentum patellae is the synovial membrane of the 

 joint, separated from the ligament, however, by a pad of 

 areolar tissue and a portion of the capsular ligament. In 

 the space behind the middle third of the patellar ligament, 

 and between it and the anterior surface of the head of the 

 tibia, is areolar tissue ; while, behind the lower third 

 of the ligament, and between it and the upper part of the 

 tubercle of the tibia, is the pretibial bursa. This bursa, 

 however, frequently extends upwards behind the middle 

 third of the ligament. 



Bursae in the anterior regionof the knee joint 

 The following bursse are found in this situation : (l) m One f 

 beneath the quadriceps extensor tendon. The upper limit 

 of this bursa is about two inches above the upper border 

 of the patella, while the lower limit is about one inch 

 above that bone. When this bursa is distended, it forms 

 a swelling, which is transverse to the axis of the limb, and 

 is about one inch, or more, in depth. This bursa fre- 

 quently communicates with the joint through a variable- 



