446 
W. L. WILLIAMS. 
main tendon of the extensor pedis of the right anterior limb had 
parted within its carpal bursa, the superior end had become un- 
distinguishably fused with the communicating division without 
leaving macroscopical traces of traumatism or inflammation. 
The ruptured end of the distal portion lay free within the bursa, 
enlarged, ecchymotic and smooth. The communicating branch 
of the tendon destined for the lateral extensor of the phalanges 
instead of consisting of one intact cord was teased out into 
numerous small fibres for a distance of two inches immediately 
in front of the carpus. The carpal bursa of the tendon appeared 
normal. 
The vastus externus muscles (Fig. Ill c) were but slightly 
modified in direction ; the rectus femoris (Fig. Ill d) assumed an 
oblique direction downwards, outwards and backwards, while 
the vastus internus (Fig. Ill a) was stretched across the femur 
just above the lower articular enlargement in an almost trans¬ 
verse direction, and seemed pale, thin and atrophied. 
The three tibio-patellar and the capsular ligaments were in¬ 
distinguishable, being represented by a thick fibrous capsule co¬ 
equal in extent with the enlarged parts. 
The femoro-patellar synovial cavities, which had at an earlier 
date apparently been much more distended, contained now about 
one and one-half pints each of an apparently normal synovia, 
along with an almost equal volume of quite firm, semi-trans¬ 
parent, faintly greenish-yellow synovial clot attached chiefly at 
the point of union between the capsular ligament and bone, and 
presenting centrally a free shredded margin three-fourths to one 
inch thick. (Figs. IV and V d.) 
The synovial clots were in places feebly adherent to the 
articular surface, which was normal, except that at the inferior 
part of the right femoral trochlea the external ridge had been 
worn away to a marked extent, denuding it of articular carti¬ 
lage and subjacent osseous tissue (Figs. IV and Yd.) As the 
patella could not at this time be brought in contact with the 
worn part, the destruction must have occurred at an early stage 
of the affection. 
