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Updated: June 21, 2025
Before the stage of cold abscess is reached, the localised swelling is to be differentiated from a gumma, from chronic forms of staphylococcal osteomyelitis, from enlarged bursa or ganglion, from sub-periosteal lipoma, and from sarcoma. Most difficulty is met with in relation to periosteal sarcoma, which must be differentiated either by the X-ray appearances or by an exploratory incision.
Cellulitis of the sole of the foot may follow whitlow of the toes. In the region of the ankle cellulitis is not common; but around the knee it frequently occurs in relation to the prepatellar bursa and to the popliteal lymph glands, and may endanger the knee-joint.
In distension of the superficial bursa, after clipping the hair over a liberal area and preparing the skin by thoroughly cleansing and painting with tincture of iodin, the capsule is incised with a bistoury. An incision about an inch in length, situated low enough to provide drainage, is made through the tissues and the contents are evacuated.
#Injuries of Bursæ.# As a result of contusion, especially in bleeders, hæmorrhage may occur into the cavity of a bursa and give rise to a bursal hæmatoma. Such a hæmatoma may mask a fracture of the bone beneath for example, fracture of the olecranon. #Diseases of Bursæ.# The lining membrane of bursæ resembles that of joints and tendon sheaths, and is liable to the same forms of disease.
As these are best illustrated in the different varieties of prepatellar bursitis, it is convenient to take this as the type. In a number of cases the inflammation is acute and the patient is unable to use the limb; the part is hot, swollen, and tender, and fluctuation can be detected in the bursa.
In his later years he founded a hostel, the Bursa Cusana, at Deventer, where he had been at school, and at Cues built a hospital for aged men and women, with a grassy quadrangle and a chapel of delicate Gothic; and there in a vaulted chamber supported by a central column he deposited the manuscripts, mainly theological but with some admixture of the classics, which he had gathered in the course of his busy life.
Under such conditions the tension should be relieved and the exudate with its contained toxins removed by making an incision into the inflamed tissues, and applying a suction bell. When the exudate has collected in a synovial cavity, such as a joint or bursa, it may be withdrawn by means of a trocar and cannula.
A ganglion is sometimes met with on the median aspect of the head of the metatarsal bone of the great toe and may be the cause of considerable suffering; it is indistinguishable from the thickened and enlarged bursa so commonly present in this situation in the condition known as bunion. [Illustration: FIG.
Patients are best given a long rest at pasture and returned to work for two or three months after an acute attack of inflammation of the bursa, lest the condition become chronic. When due consideration is given the pathology of such cases, the frequent unsatisfactory termination under the most careful treatment, is readily understood. Contusions of the Triceps Brachii. Anatomy.
Among the second are these: Medicago lupulina, or nonesuch; Trifolium repens, or white clover; Lathyrus pratensis, or meadow lathyrus; Capsella bursa pastoris, or shepherd's purse; Vicia peregrina, or broad-podded vetch; Convolvulus arvensis, or small bindweed; Pterotheca nemausensis, a sort of hawkweed; and Poa pratensis, or smooth-stalked meadow-grass.
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