12: Common MSK swellings Flashcards
What features of a soft tissue swelling suggest it is benign?
Small
Fluctuates in size
Fluid-filled
Well defined
Soft
What signs suggest a soft tissue swelling may be malignant?
Large
Growing rapidly
Solid
Poorly defined
Irregular
Constitutional symptoms
Lymphadenopathy
What investigations are used to view soft tissue swellings?
Ultrasound
MRI
What is a benign tumour of fat called?
Lipoma
Are lipomas painful?
No
What are common hand swellings made by outpouchings of the synovial cavity?
Ganglion cysts
A cyst found at the DIP joint is called a ___ cyst.
mucous
What should a ganglion cyst do when a bright light is shone on it?
Transilluminate
i.e the light should pass through
What are the surgical options for treating symptomatic ganglion cysts?
Aspiration (50% recurrence rate)
Excision
Only ___ ganglion cysts are indicated for excision.
painful
Ganglion and mucous cysts are associated with which joint disease?
OA
What is the 2nd most common hand swelling after ganglion cysts?
Giant cell tumours
What is a feature of giant cell tumours histologically (apart from the giant cells)?
Pigmented
due to haemosiderin deposits
If giant cell tumours are painful, how are they managed?
Excision
What is a condition, affecting the knee, involving pigmented swellings similar to giant cell tumours?
Pigmented villonodular synovitis
or PVNS
What are some consequences of PVNS of the knee?
Joint destruction > Arthritis
eventually leading to knee replacement
What swelling appears behind the knee?
What causes it?
Baker’s cyst
Synovial fluid leaks through into bursa of semimembranosus or gastrocnemius (posterior thigh muscles)
Baker’s cysts in children tend to…
In adults, the management tends to be…
resolve themselves
leave them alone in adults (high recurrence)
What pouches of fluid around joints can become inflamed?
Bursae
What are four common locations for bursitis to occur?
Olecranon
Prepatellar
Infrapatellar
1st metatarsal head (bunion)
How is bursitis treated surgically?
Bursectomy
What is an abscess?
Inflammatory nodule containing pus
What may cause an abscess?
Cellulitis
Infected wound
Epidermoid cyst
Blocked sebaceous gland
Do abscesses fluctuate in size?
Yes
How are abscesses treated?
Drained
What is myositis ossificans?
Trauma causes IM bleeding which then ossifies for unknown reasons
Is myositis ossificans painful?
No
What are:
a) angiosarcomas
b) fibrosarcomas
c) liposarcomas
d) rhabdomyosarcomas?
Malignant tumours of…
a) blood vessels
b) fibrous tissue
c) fat
d) skeletal muscle
What investigation must be performed if you think a tumour is malignant?
Biopsy
