BACK MASS
BACK MASS: Excerpt from Differential Diagnosis in Primary Care
It is not uncommon for a patient to complain of a lump on his or her
back. Most of the time, the lesion is a sebaceous cyst or lipoma. However,
there are other types of back masses, and a simple method of recall is
needed. Anatomy is the key. If the mnemonic MINT is applied to
most of these structures, all of the important lesions can be recalled.
Skin
M—Malformations include pilonidal cysts and sebaceous cysts.
I—Inflammation suggests carbuncles and furuncles.
N—Neoplasms include hemangiomas, neurofibromas, lipomas, and
metastatic tumors.
T—Trauma, of course, suggests contusions.
Subcutaneous tissue and fascia
M—Malformations include hernias of Petit triangle.
I—Inflammation suggests lesions such as rheumatoid
nodules and abscesses.
N—Neoplasms encompass those mentioned above.
T—Trauma includes contusions and lacerations. Anasarca may produce
edema of the back.
Muscle
Muscle is frequently nodular in fibromyositis, and a bursa
may occasionally swell significantly. Rupture of a muscle or ligament and
contusions are traumatic lesions that may present a mass. Muscle spasm from
back injuries is often significant enough to cause a “mass.”
Bone
Lesions of the bone are usually responsible for the deeper
masses in the back.
M—Malformations include spina bifida, which may be occult or
manifest as a swelling such as meningocele or meningomyelocele.
I—Inflammation suggests the gibbus of Pott disease (tuberculosis of
the spine).
N—Neoplasm suggests metastatic neoplasm and multiple myeloma of the
spine which may protrude from beneath the skin.
T—Trauma suggests the obvious mass of a fracture dislocation or
hematoma of the periosteum of the spine.
Retroperitoneal structure
Wilms tumors of the kidney and
perinephric abscesses may present as a mass in the back.
Approach to the Diagnosis
With skin lesions, excision or biopsy is frequently the best approach.
Masses of the deeper structures cannot be approached as aggressively until
certain conditions have been ruled out by computed tomography (CT) scans and
bone scans. If a meningocele or similar congenital lesion is suspected, a
neurosurgeon must be consulted.
Other Useful Tests
-
X-ray of the thoracic or lumbosacral spine (malformations,
neoplasm)
-
Magnetic resonance imaging (MRI) of the thoracic or lumbar spine
(malformation, neoplasm)
-
Intravenous pyelogram (IVP) (Wilms tumor, perinephric abscess)
-
Tuberculin test
-
Serum protein electrophoresis (multiple myeloma)
-
Myelogram
-
Exploratory surgery
Pictures
Book Source Details
- Book Title: Differential Diagnosis in Primary Care
- Author(s): R. Douglas Collins MD, FACP
- Year of Publication: 2007
- Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.
More About Back conditions
More Medical Textbooks Online about Back conditions
Review other book chapters online related to Back conditions:
Medical Books Excerpts
- BACK PAIN
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
- [ read ]
- SCOLIOSIS
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
- [ read ]
- Back Pain
- "In A Page: Pediatric Signs and Symptoms" (2007)
- [ read ]
- Scoliosis
- "In A Page: Pediatric Signs and Symptoms" (2007)
- [ read ]
- BACK MASS
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
- Back pain
- "Handbook of Signs & Symptoms (Third Edition)" (2006)
- [ read ]
- Back Pain
- "A Pocket Manual of Differential Diagnosis" (1999)
- [ read ]
- Scoliosis
- "Professional Guide to Diseases (Eighth Edition)" (2005)
- [ read ]
- Back pain
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Low Back Pain
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
- Back pain
- "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
- [ read ]
- Back pain
- "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
- [ read ]
- Back Pain
- "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
- [ read ]
- Back pain
- "Nursing: Interpreting Signs and Symptoms" (2007)
- [ read ]
- BACK MASS
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
» Next page: Learning Problems (The 5-Minute Pediatric Consult)
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
