lling in the
region of the trochanter followed by abscess formation, the movements
are less restricted than in disease of the joint.

In _psoas abscess_ associated with spinal disease, or in _disease of
the bursa underneath the psoas_, the limb is flexed and everted, there
may be lordosis, and the patient may limp in walking, but the
movements at the hip are restricted only in the directions of
extension and inversion, while in hip disease they are restricted in
all directions.

_New-growths_ in the vicinity of the hip--especially central sarcoma
of the upper end of the femur--are difficult to differentiate from hip
disease without the help of the X-rays.

Among other conditions which by interfering with the free mobility of
the hip may simulate hip disease, are appendicitis, inflammation of
the glands in the groin, staphylococcal disease of the upper end of
the femur, and sciatica.

The diagnosis _from other diseases of the hip-joint_ is made by
careful consideration of the history, symptoms, and X-ray appearances.

#Prognosis.#--The prognosis in hip disease is more serious than in
tuberculosis of other joints, excepting only those of the spine, and
it is most unfavourable when there are gross lesions of the bones and
infected sinuses.

Whatever the stage of the disease, recovery is a slow process, and
even in early and mild cases it seldom takes place in less than one or
two years, and is liable to be attended with some impairment of
function. During the process of cure, complications are liable to
occur, and after apparent recovery relapses are not uncommon. When
arrested during the initial stage, recovery may be complete; but when
there has been destruction of the articular surfaces, there is apt to
be ankylosis of the joint and shortening of the limb.

In cases which terminate fatally, death usually results from
meningeal, pulmonary, or general tuberculosis, or from pyogenic
complications and waxy degeneration.

#Treatment.#--A large proportion of cases recover under conservative
treatment, and the functional results are so much better than those
following operative interference that unless there are special
indications to the contrary, conservative measures should always be
adopted in the first instance.

_Conservative Treatment._--The first essential is to take the weight
off the limb and secure its fixation in the attitude of almost
complete extension and moderate abduction. When the symptoms are wel