. Modern surgery, general and operative. of the tendon-sheath with J serum. The serum contains rice, riziform, or melon- pj,. Method of seed bodies, and the wall of the tendon-sheath is here suturing the annular liga-and there thickened and caseating. Later in the case rnent of the wrist.the interior of the tendon-sheath becomes lined with tuberculous granulations and a tuberculous abscess may form. Rice bodies aresometimes fibrinous masses, are sometimes pieces of separated and deadrecently formed fibrous tissue, and are sometimes masses of proliferating cells.In tuberculous cases the swellin
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. Modern surgery, general and operative. of the tendon-sheath with J serum. The serum contains rice, riziform, or melon- pj, . Method of seed bodies, and the wall of the tendon-sheath is here suturing the annular liga-and there thickened and caseating. Later in the case rnent of the wrist.the interior of the tendon-sheath becomes lined with tuberculous granulations and a tuberculous abscess may form. Rice bodies aresometimes fibrinous masses, are sometimes pieces of separated and deadrecently formed fibrous tissue, and are sometimes masses of proliferating cells.In tuberculous cases the swelling is firm or doughy when due to granula-tion tissue, but is fluctuating when due to fluid. Grating is marked. Tuberclebacilli are present in the fluid or in the granulation tissue. Tuberculous thecitisis most common about the wrist, constituting the so-called compound ganglion(Fig. 513)- Treatment.—Tuberculous cases are treated as follows: If there is a fluideffusion and no rice bodies, make a small incision, wash out with salt solu-. FiG. 515.—Ganglion of extensor tendon-sheaths of the wrist. tion, introduce iodoform emulsion or formalin-glycerin, and close the wound.In cases in which there are rice bodies, open the sheath, evacuate the con-tents, scrape the walls thoroughly, inject iodoform emulsion or formalin-glycerin, and close the wound. (If the annular ligament requires division, stitch it before closing the wound—Fig. 514.) In cases with extensive thick-ening apply an Esmarch bandage, make a large incision, and remove allinfected tissue from the sheath, around the sheath, and from the tendon. Intuberculous thecitis Biers method (see page 122) may be of service and so maythe x-rays. In ordinary traumatic thecitis use for the first few days rest asso-ciated with applications of ichthyol. Later employ hot and cold douches, mas- 8i4 Diseases and Injuries of Muscles, Tendons, and Bursa? sage and passive movements, strapping of the part, inunctions of ichthyol, andthe ho