A treatise on orthopedic surgery . y applied over the affected part is of Chronictenosynovitis may follow injury or it may be the result ofgonorrhoea or other infectious disease. In chronic cases whenthe palliative treatment is ineffective, thorough removal of theaffected sheath is indicated. (See Achilobursitis.) Tuberculous Tek^osyxovitis.—A persistent and increasingswelling of a tendon sheath always suggests tuberculous such instances the sac is thickened and often contains theso-called rice bodies. Prompt and complete removal of the dis-eased sheath is indicated, and b
A treatise on orthopedic surgery . y applied over the affected part is of Chronictenosynovitis may follow injury or it may be the result ofgonorrhoea or other infectious disease. In chronic cases whenthe palliative treatment is ineffective, thorough removal of theaffected sheath is indicated. (See Achilobursitis.) Tuberculous Tek^osyxovitis.—A persistent and increasingswelling of a tendon sheath always suggests tuberculous such instances the sac is thickened and often contains theso-called rice bodies. Prompt and complete removal of the dis-eased sheath is indicated, and by this means a permanent curemay be attained in most instances. 480 OBTHOPEDIC SUBGEEY. SWELLING ABOUT THE ANKLES. Occasionally often in combination with weak feet there aredistinct swellings about the ankles. The most common is mfront of the external malleoli. This is apparently an extrusionfrom the joint made up of synovial and fatty tissue. In mostinstances the patients are fat and the apparent cause is over-weight. Fig. Painful swellings about the ankles, common in over-weighted subjects. The patients usually complain of weakness and treatment aside from reduction of weight, and support forthe weakened arch, is massage, strapping and bandaging. Theoperative removal of the swollen tissue is indicated in obstinatecases. CHAPTER XII. DISEASES AND INJUEIES OE THE ARTICULATIONS OF THEUPPEE EXTEEMITY. TUBERCULOUS DISEASE OF THE SHOULDER-JOINT. Disease at the shoulder is very uncommon in childhood. Ina total of 453 cases of tuberculous disease treated at the Vander-bilt clinic 210 were cases of Potts disease. In 6 of the remain-ing 243 cases the disease was of the shoulder-joint ( percent.). In 1883 consecutive cases of joint disease—Potts diseasebeing excluded—^treated in the out-patient department of theHospital for Euptured and Crippled in a period of five years, Fig. 319.
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