#Tuberculous disease# is met with chiefly in young adults, but may occur at any age. It usually originates in the synovial membrane, but foci are frequently present in the carpal bones, and less commonly in the lower ends of the radius and ulna, or in the bases of the metacarpals. The clinical features are almost invariably those of white swelling, which is most marked on the dorsum where it obscures the bony prominences and the outlines of the extensor tendons. Wasting of the thenar and hypothenar eminences, and filling up of the hollows above and below the anterior annular ligament, render the appearance on the palmar aspect characteristic. The attitude is one of slight flexion with drooping of the hand and fingers. The fingers become stiff as a result of adhesions in the tendon sheaths, and the power of opposing the thumb and fingers may be lost. Pain is usually absent until the articular surfaces become carious. Softening of the ligaments may permit of lateral mobility, and sometimes partial dislocation occurs. Abscess may be followed by sinuses and infection of the tendon sheaths, especially those in the palm. The localisation of disease in individual bones or joints can be determined by the use of the X-rays. _Treatment._--Conservative measures may be persevered with over a longer period than in most other joints. The forearm, wrist, and metacarpus are immobilised in the attitude of dorsal flexion, while the fingers and thumb are left free to allow of passive movements. It may be necessary to give an anæsthetic to obtain the necessary degree of dorsiflexion. To inject iodoform, the needle is inserted immediately below the radial or the ulnar styloid process. Sometimes the carpal bones are so soft that the needle can be made to penetrate them in different directions. Operative treatment is indicated in cases which resist conservative measures, or when the general health calls for speedy removal of the disease. _Other diseases of the wrist_ are comparatively rare. They include pyogenic affections, such as those resulting from infective conditions in the palm of the hand, different types of gonorrhœal, rheumatic, and gouty affections, and arthritis deformans. An interesting feature, sometimes met with in arthritis deformans, consists in eburnation of the articular surfaces of the carpal bones, although the range of movement is almost nil. THE HIP-JOINT Owing to the depth of this joint from the surface, it is not possible to detect the presence of effusion or of synovial thickening as readily as in other joints, hence in the recognition of hip disease we have to rely largely upon indirect evidence, such as a limp in walking, an alteration in the attitude of the limb, or restriction of its movements.