266 REPORT OF THE HARVARD AFRICAN EXPEDITION 
in which fibrous tissue predominated and the other of yellow, more softened 
tissue. In the latter were found large and anastomozing thick cells in the retic- 
ulum. Here some of the thick cells were free in the form of macrophagocytes. 
There were also some giant cells and innumerable plasma cells in the interstitial 
spaces, also large numbers of polynuclear cells and some eosinophils. Finally 
there were numerous blood and lymph capillaries which consisted of only one 
layer of flattened or raised epithelial cells. Between the inflammatory zone in 
the interior and that of sclerosis, there existed transitional appearances. ‘The 
collagen elements in the latter gradually predominated over the cellular, and the 
fibroblasts disposed themselves in thick bundles separated by interstices and 
<i Ji 
a b ee 
ues 
Cs Pay ae 
No. 200. — Section of periphery of nodule. No. 201. — Section nearer center of nodule. 
Objective D and compensating ocular 4 _ Objective D and compensating ocular 4 

Juxta-articular nodules, Case 221 
forming a mosaic of fixed flattened cells. Between the more central focus of 
necrosis and the inflammatory area there occurred changes which gradually 
caused the degenerative tissue to act as a foreign body within the fully sclerosed 
tissue. Jeanselme further points out that the microscopic examination revealed 
nothing as to the nature of the nodule. To him they certainly did not reveal 
evidence of syphilis or tuberculosis, nor any suggestion of xanthoma, all of which 
have characteristic structures. With reference to their origin, he considered the 
possibility of tophi, but concluded against such an idea. He points out that the 
nodules are not fibromata nor sclerosed forms of peri-articular bursae. It has 
seemed of importance to give at some length, Jeanselme’s ideas about this con- 
dition which he originally described in this manner. 
From the more recent literature upon the subject, juxta-articular nodules 
have usually been generally regarded as any subcutaneous tumors, freely moy- 
able, of firm consistency, and situated in the neighborhood of the joints, particu- 
larly about the trochanter, olecranon and lower end of the femur, not adherent 
