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Stories in the Congo grow with extraordinary rapidity and my attack of synovitis had been converted into a serious illness before it reached the capital. A room had therefore, been prepared at the Croix Rouge in which I was soon comfortably installed. The hospital consists of eight sets of rooms arranged in four buildings, separated from each other, but with the verandahs connected by balconies.

With the destruction of the ligaments, the stability of the joint is lost, and it becomes disorganised. The clinical features vary with the extent of the infection. When this is confined to the synovial and peri-synovial tissues acute serous and purulent synovitis there is the usual general reaction, associated with pyrexia and great pain in the joint.

#Pneumococcal affections of joints#, the result of infection with the pneumococcus of Fraenkel, are being met with in increasing numbers. The local lesion varies from a synovitis with infiltration of the synovial membrane and effusion of serum or pus, to an acute arthritis with erosion of cartilage, caries of the articular surfaces, and disorganisation of the joint.

The commonest type is a chronic synovitis or hydrops, in which the joint very often the knee becomes filled with a serous or sero-fibrinous exudate. There are no reactive changes in the synovial membrane, cellular tissue, or skin, nor is there any fever or disturbance of health. The movements are free except in so far as they are restricted by the amount of fluid in the joint.

Injuries to the scapulohumeral joint may be the result of kicks, runaway accidents or bruises from the collar, and there may result, because of such injuries, reactionary inflammation which will vary in intensity from the mildest synovitis to the most severe arthritis, causing more or less lameness. Treatment.

As has been previously referred to, there always exists a peculiar suspension of carpal flexion in all cases of carpitis. Non-infective wounds which may cause open joint are not necessarily productive of an active carpitis a synovitis may be the extent of the disturbance.

If the synovitis or arthritis remains non-infected and the wound, traumatic or surgical, is not too large, healing by granulation occurs, and the discharge of synovia ceases.

#Definition of Terms.# The term synovitis is applied to any reaction which affects the synovial membrane of a joint. It is usually associated with effusion of fluid, and this may be serous, sero-fibrinous, or purulent.

Wounds invading the tissues adjacent to joints, when these wounds are of considerable extent, cause inflammation of such articulations by contiguous extension of inflammation. As long as an injury remains practically aseptic, or if infected and the septic process does not involve the joint proper by direct extension, no more serious disturbance than a simple synovitis will result.

Gross, in his excellent work on surgery, says, "synovitis, in the great majority of cases, arises from the effects of rheumatism, gout, eruptive fevers, syphilis, scrofula, and the inordinate use of mercury." Prof.