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Updated: May 4, 2025
Of the numerous bursæ in the popliteal space, that between the semi-membranosus and the medial head of the gastrocnemius is most frequently the seat of disease, which is usually of the nature of a simple hydrops, forming a fluctuating egg-or sausage-shaped swelling at the medial side of the popliteal space. It is flaccid in the flexed, and tense in the extended position.
These changes in the synovial membrane are often associated with an abundant exudate or hydrops. These degenerative and hypertrophic changes, while usually attended with marked restriction of movement and sometimes by "locking" of the joint, practically never result in ankylosis.
When the main incidence of the infection affects the synovial membrane, the clinical picture may assume the form of a hydrops, or of an empyema in which the joint is filled with pus. It is well seen in joints which are superficial such as the knee, ankle, elbow, and wrist.
Urgebat praecipue subsistens prorsus et intercepta respiratio ad prima somni initia; unde somnus prorsus prohibebatur, cum formidabili strangulationis molestia. Hinc hydrops pedum, crurum, femorum, scroti, praeputii, et abdominis. Quae tamen omnia sublata.
Their presence may be recognised, especially in the knee, by the crepitating sensation imparted to the fingers of the hand grasping the joint while it is flexed and extended by the patient. The treatment is directed towards the disease underlying the hydrops. If it is desired to empty the joint, this is best done by open incision.
Anatomy Normal and adventitious bursæ Injuries: Bursal hæmatoma DISEASES: Infective bursitis; Traumatic or trade bursitis; Bursal hydrops; Solid bursal tumour; Gonorrhœal and suppurative forms of bursitis; Tuberculous and syphilitic disease Tumours Diseases of individual bursæ in the upper and lower extremities. A bursa is a closed sac lined by endothelium and containing synovia.
Cystic distension of bursæ which communicate with the joint is most often met with in the region of the knee in cases of long-standing hydrops. It was suggested by Morrant Baker that cystic swellings may result from the hernial protrusion of the synovial membrane between the stretched fibres of the capsular ligament, and the name "Baker's cysts" has been applied to these.
As the term synovitis merely refers to the tissue involved, it should always be used with an adjective such as gouty, gonorrhœal, or tuberculous which indicates its pathological nature. The terms hydrops, hydrarthrosis, and chronic serous synovitis are synonymous, and are employed when a serous effusion into the joint is the prominent clinical feature.
Montesinos. Nothing, except more books. Sir Thomas More. "Crescit, indulgens sibi, dirus hydrops." Montesinos. Nay, nay, my ghostly monitor, this at least is no diseased desire. If I covet more, it is for the want I feel and the use which I should make of them.
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