4 22 



THE INFERIOR EXTREMITY 



accompanied by a reactionary effusion within the joint. If 

 this effusion occurs early in the disease, adhesions may form 

 between the synovial membrane of the femoral neck and that 

 lining the capsule and delay the extension of the disease into the 

 joint. Such adhesions give rise to limitation of movement, 



Labruni glenoidale 



Head of femur 



Acetabular pad 



Capsule of hip-joint 



Articular artery 



Transverse acetabular 

 ligament 



FIG. 125. Oblique Section through Right Hip-Joint, showing the relation 

 of the Capsule to the Epiphysis of the Head of the Femur. 



Light blue = articular cartilage. Green = periosteum. 



Striped blue = ligaments. Red = synovial membrane. 



which may be the first sign of the disease. In the absence 

 of adhesions, the disease rapidly becomes intra- synovial and 

 attacks the articular cartilage. 



If the disease spreads across the neck it may actually separate 

 the head or render it so weak that a diastasis readily occurs. 

 Only very exceptionally does the disease perforate the epiphyseal 

 cartilage and invade the epiphysis from without the joint. 



