mohd afiq izzuddin bin rossli (1001336000) (soft tissue swelling) 543. 15-16

8/17/2019 Mohd Afiq Izzuddin Bin Rossli (1001336000) (Soft Tissue Swelling) 543. 15-16

1/23

Soft Tissue Swelling(Hand & Knee)

M. Aq Izzuddin bin

11!!


2/23

S#ena$io %b

atient '$esented wit stiness of and and nge• *ie$ential diagnosis +

1. T$igge$ ,inge$

-. *u'ut$en/s #ont$a#tu$e


3/23

1) T$igge$ ,inge$ (*igitalteno0aginosis)

• ,leo$ tendon be#o2e t$a''ed b ti#3ening at ent$an#e to its seat4 #ausing te nge$ to ben(5t$igge$ nge$6)

• Se#onda$ nodule #an de0elo' on te tendon.

• 7nde$ling #ause is un3nown4 but #o22onest in

wit *iabetes.

• eo'le wit RA #an also de0elo'ed te sno0ialti#3ening o$ int$a8tendinous nodules wi# alsote t$igge$ing.


4/23

9lini#al ,eatu$e:

• Tu2b4 $ing and 2iddle nge$s 2ost #o22onl ae#ted; so2se0e$al nge$s a$e ae#ted.

• atient noti#es a #li#3 as te nge$ is


5/23

Infantile T$igge$ Tu2b

• a$ents so2eti2es noti#e tattei$ bab o$ infant #annotetend te tu2b ti'.

• Te diagnosis is often 2issed4 o$te #ondition is w$ongl ta3en

fo$ a >dislo#ation/.• ?e$ o##asionall te #ild g$ows

u' wit te tu2b 'e$2anentlbent.


6/23

T$eat2ent

In adults4 ea$l #ases 2a be#u$ed b an in=e#tion of

#o$ti#oste$oid.

Re#u$$ent t$igge$ing u' to "2onts late$ o##u$s in o0e$ !'e$ #ent of 'atients @ 'a$ti#ula$lounge$ 'atients and tose witdiabetes4 wo 2a ten need ase#ond in=e#tion.

Ref$a#to$ #ases need o'e$ation

In babies it is wo$t waiting until

te #ild is about ! ea$s old4 as


7/23

-) *u'ut$en/s #ont$a#tu$e

• A nodula$ 'e$t$o' and#ont$a#tu$e of tesu'e$#ial 'al2a$ fas#ia('al2a$ a'oneu$osis).

• Autoso2al do2inant t$ait

• Most #o22on in 'eo'le ofu$o'ean (es'e#iallAnglo8Saon) des#ent.

• Males B fe2ales;


8/23

9lini#al featu$es

• Codula$ ti#3ening in te 'al2.D$aduall etends distall toin0ol0e te $ing o$ little nge$.

• ain.

• Eften bilate$al. Te 'al2 is

'u#3e$ed4 nodula$ and ti#3. If tesub#utaneous #o$ds etend intote nge$s te 2a '$odu#e


9/23

Manage2ent

• E'e$ation is indi#ated if tedefo$2it is a nuisan#e o$

$a'idl '$og$essing..• Su$ge$ does not #u$e tedisease4 it onl 'a$tiall#o$$e#ts te defo$2it.

• Cigt s'linting fo$ a few 2onts2a $edu#e $e#u$$en#e.

• S3in g$afting @ se0e$e s3inin0ol0e2ent4 st$ong fa2ilisto$4 oung 'atient.

• A2'utation o$ =oint fusion @se0e$e4 $e#u$$ent disease in


10/23


11/23

S#ena$io %#

• FGea$s old lad '$esent wit te swelling at te'o'liteal fossa. Se/s a 3nown #ase of Reu2atoA$t$itis.

*ie$ential diagnosis +


12/23

Knee Swelling (Int$odu#tion)

• Ete$ tan in=u$4 3nee also '$one to a nu2be$ odiso$de$ wi# '$esent essential as ‘swelling’

• Swelling of te 3nee is often 'ainless until te tisbe#o2e tense and #ausing 'ain.

• Swelling of te 3nee #an be di0ided into F big g$1. Swelling of te enti$e 3nee =oint

-. Swelling in f$ont of te 3nee =oint

!. Swelling at te ba#3 of te 3nee =oint

F. on sweeling


13/23

1) Swelling of te enti$e =oint

1) A#ute swelling of te enti$e swellinga) ost8T$au2ati# Hae2a$t$osisb) leeding *iso$de$

#) A#ute Se'ti# A$t$itis

d) T$au2ati# Sno0itis

e) Ase'ti# Con8T$au2ati# Sno0itis

f) Dout A$t$itis

-) 9$oni# swelling of te =oint

g) A$t$itis

a) Esteoa$t$itis

b) Reu2atoid A$t$itis

#) Tube$#ulous a$t$itis

b) Sno0ial *iso$de$


14/23

-) Swelling in f$ont of te oint

1. $e8'atella$ u$sitits (>/House2aid Knee//)-. Inf$a8'atella$ u$sitis (59le$g2an/s Knee//)

!. es8Anse$inus (*ee' u$sitis)

Bursitis•.function of the bursa is to facilitate movement of tendons a

over bony prominences.

•.Excessive frictional forces from overuse, trauma, systemic d

(e.g., rheumatoid arthritis, gout), or infection may cause burs


15/23

$e8'atella$ u$sitis

• It is a ,lu#tuant swelling #onned to te f$ont of te 'atellate =oint itself

• Te swelling due not to '$essu$e but #onstant f$i#tion betws3in and bone.

• Mainl o##u$ in wo$3e$s wo do not use te '$ote#ti0e 3nee


16/23

Inf$a8'atella$ u$sitis (9le$g2aKnee)

• Swelling below te 'atella and su'$#ial to te 'liga2ent4 2o$e distall swelling #o2'a$e to '$e8bu$sitis.

• E##u$ in 'eo'le wo 3neeling 2o$e u'$igtl.


17/23

es8anse$inus (*ee' u$sitis)

• Its an inflammation of the sartorius bursa located omedial side of the tibia just below the knee and undconjoint tendon and is manifested by pain on climbin


18/23

T$eat2ent of u$sitis

1) 7ninfe#ted u$sitis1. ,i$2 bandaging-. Rest & A0oid 3neeling

!. As'i$ation (if needed)

-) Infe#ted u$sitisF. Rest & a0oid 3neeling

G. Antibioti#

". As'i$ationJ#ision (if needed)


19/23

!) Swelling at te ba#3 of te 3n =oint

1) o'liteal 59st6 (a3e$/s 9st)•)ulging of te 'oste$io$ #a'sule and sno0ial e$niation

'$odu#e a swelling in te 'o'liteal fossa ainless u2'

•)In#iden#e: Elde$ 'eo'le B oung

•)o#ation: Midline of te 3nee o$ below of te =oint

•)Mo$e li3el to be #aused b RA & EA


20/23

T$eat2ent:

• E##asionall te #st 2a $u'tu$e4 #ausing te sno0ial #os'ill into te 2us#le 'lanes #ausing ain & swelling of te #

(Tis #an be 2ista3en as *?T)

1) As'i$ation (2a needed to $esol0e te swelling)

-) In=e#tion of d$o#o$tisone

!) #ision not ad0isedL

(be#ause $e#u$$en#e in #o22on4 unless te unde$ling #ondt$eated)


21/23

-) Se2i8Me2b$anous u$sa• u$sa between te se2i2e2b$anous and te 2edial e

gast$o#ne2ius 2a be#ao2e enla$ged and #ausing u2' beind te 3nee

• o#ation: Sligtl to te 2edial side of te 2idline and 2#ons'i#uous wit 3nee st$aigt

• Te lu2' is


22/23

F) on Swelling a$ound te 3n

• Knee is $elati0el su'e$#ial =oint4 an bon swedistal fe2u$ and '$oi2al 'a$t of tibia a$e often and 'al'able

• Most #o22on #ondition is Esteo#ond$o2ata


23/23

Tan3 ou

mohd afiq izzuddin bin rossli (1001336000) (soft tissue swelling) 543. 15-16

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