...
Is there a history of trauma? Trauma, of course, may cause fractures and subperiosteal hematomas.
Is the patient a child or an adult? Children are more likely to have Ewing's tumors, scurvy, rickets, syphilis, battered baby ... DIAGNOSTIC WORKUP
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... Smaller localized, freely movable masses are the sebaceous cysts, hematomas, lipomas, and lymph nodes. Masses that seem to be attached to the skull are osteomas, dermoid cysts, and sarcomas. Brain tumor tissue may occasionally protrude out beneath the... DIAGNOSTIC WORKUP
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...
Is it tender? A tender vulval or vaginal mass would suggest vulvitis, hematoma, acute bartholinitis, or urethral caruncle.
Is it reducible? A reducible vulval or vaginal mass would suggest pudendal hernia, varicocele, cystocele ... DIAGNOSTIC WORKUP
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...
Is it reducible? If the mass is reducible, it is most likely a femoral hernia or saphenous varix.
Is there an associated kyphotic curvature of the spine? The findings of a kyphotic curvature of the spine suggest a psoas abscess, which is ... DIAGNOSTIC WORKUP
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...
Is it painful? A painful rectal mass should suggest perirectal abscess, thrombosed hemorrhoid, anal ulcer, ruptured ectopic pregnancy, tubo-ovarian abscess, and pelvic appendix.
Is it soft or ... DIAGNOSTIC WORKUP
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...
Low back pain is the second most common cause of doctor visits in the U.S. and is the most common cause of disability. Up to 90% of the population will experience back pain during their lives. Studies show that, at any given time, up to 20% of the population is experiencing low back... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Any mass in the anal canal or rectum should be considered cancer until ruled out. Colorectal cancer must be considered, as it is the second leading cause of cancer death in the U.S., with greater than 40,000 mortalities each year. Early detection and aggressive... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Scrotal masses and swelling can involve the contents of the scrotum, the wall of the scrotum, and the scrotum itself. Ultrasonography should be used liberally in evaluating scrotal masses. All solid masses must be evaluated by surgical exploration. Torsion of the testis should... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... Nothing is more challenging to diagnose than a case of low back pain. That is why it is so important to have an extensive list of causes in mind before approaching the patient. Anatomy forms the basis for developing such a list ( Table 45 ).
... READ EXCERPTS »
... Aside from the common external hemorrhoids (which will not be seen in many cases unless the patient is asked to bear down), anal masses may include any of the following:
Skin tag from previous ruptured or incised hemorrhoids
Sentinel piles
... READ EXCERPTS »
... 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
... READ EXCERPTS »
... In developing the differential diagnosis of an epigastric mass, one merely needs to visualize the anatomy of the epigastrium from skin to spine. The conditions are presented in outline form in Table 5 , but the important conditions are emphasized in the
... READ EXCERPTS »
... When the clinician tries to recall the causes of a mass in the extremities, he or she should consider the anatomy. As the clinician dissects downward from the skin, he or she encounters the subcutaneous tissue, veins, muscles, ligaments, bursae, arteries, lymph nodes, nerves
... READ EXCERPTS »
... More physicians have been fooled by a hypogastric mass than by a mass in any other area. How many times can you recall the mass disappearing on the operating table after catheterization of the bladder? More often than not, the mass is more apparent than
... READ EXCERPTS »
... Most of these lesions are tumors, but because some are caused by other etiologies, it is well to use the mnemonic MINT to review the possibilities.
M—Malformations include dermoid cysts, ranula, Wharton duct cysts or stones, mucous cysts, and
... READ EXCERPTS »
... Because most orbital masses cause exophthalmos, the differential diagnosis of the two is very similar (for illustration see section on exophthalmos, page 193). The best method to use to arrive at the causes is to visualize the anatomy of the orbit and then to think
... READ EXCERPTS »
... Masses of the skin may be better termed nodules if they are larger than 0.5 cm and are not just neoplastic in origin. The term VINDICATE serves as a useful mnemonic to recall the important skin masses. When the physician is considering the cause of a
... READ EXCERPTS »
... When the clinician lays his or her hand on the right upper quadrant (RUQ) and feels a mass, he or she should visualize the anatomy and the differential diagnosis should become clear. Proceeding from the skin, the physician encounters the subcutaneous tissue,
... READ EXCERPTS »
... A localized mass on the head is usually a skin lesion, a lesion of the bone, or a protrusion of intracranial tissue through the bone. An extensive discussion of skin masses may be found on page 469, but most head masses originating from the skin are sebaceous cysts,
... READ EXCERPTS »
... To quickly develop a list of etiologies of a left lower quadrant (LLQ) mass, visualize the anatomy of the area. Compared to the RUQ, the number of organs there is few. Beneath the skin, subcutaneous tissue, fascia, and muscle are the sigmoid
... READ EXCERPTS »
... The differential diagnosis for left upper quadrant (LUQ) masses is not a great deal different from that of the RUQ. The anatomy is similar: just replace the liver with the spleen and the gallbladder with the stomach. The presence of the aorta on the
... READ EXCERPTS »
... Although anatomy may assist somewhat in developing the differential here, it is probably an unnecessary exercise because the mnemonic MINT will bring to mind virtually all the etiologies.
M—Malformation reminds one of the broad nose of cretinism, Down
... READ EXCERPTS »
... Anatomy is once again the key to developing a differential diagnosis of a right lower quadrant (RLQ) mass. Underneath the skin, subcutaneous tissue, fascia, and muscle, lie the cecum, appendix, terminal ileum, iliac artery and vein, and ileum. In the female, the fallopian
... READ EXCERPTS »
... Two groups of neonates are born weighing less than the normal minimum birth weight of 5½ lb (2,500 g) — those who are born prematurely (before 37 weeks’ gestation) and those who are small for gestational age (SGA). Premature... History and physical examination ... Medical causes ... Special considerations ... Pictures
... READ EXCERPTS »
... Aging (especially postmenopause)
Immobilization
Nutritional causes
Calcium or vitamin D deficiency, or both
Malnutrition, malabsorption
... READ EXCERPTS »
... Nutrient Deficiency
Iron deficiency
Chronic blood loss
Pregnancy
Dietary deficiency
... READ EXCERPTS »
... Anterior
Substernal thyroid
Thymoma
Lymphoma
Germinal cell neoplasm (e.g., dermoid)
Ascending aortic aneurysm
... READ EXCERPTS »
... Osteoporosis is a metabolic bone disorder in which the rate of bone resorption accelerates while the rate of bone formation slows down, causing a loss of bone mass. Bones affected by this disease lose calcium and phosphate salts and thus become porous, brittle, and abnormally... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Two groups of neonates are born weighing less than the normal minimum birth weight of 5½ lb (2,500 g)—those who are born prematurely (before the 37th week of gestation) and those who are small for gestational age (SGA). The premature neonate weighs an appropriate amount for his... Emergency Interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
... READ EXCERPTS »
... Pepi Granat and Omart Robaina
The term “bone cyst” usually denotes simple or solitary bone cyst, which is a benign, smooth, lytic lesion, usually found in children in the metaphysis of long bones, especially the humerus or femur. It can also be... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
... READ EXCERPTS »
... Stephen Davis
Approach Low back pain is a common problem with many causes. The differential diagnosis can be grouped into three over-lapping categories: urgent (“red flag”) diagnoses, structural (musculoskeletal) problems,... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
... READ EXCERPTS »
... Pepi Granat
Although most mediastinal masses are discovered incidentally on chest radiographs, symptoms can sometimes provide clues enabling the timely ordering of these films. The mediastinum is defined as the extrapleural space within the... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
... READ EXCERPTS »
... Robert L. Hatch
Scrotal masses are common, occurring in all age groups, from infants to elderly men. In fact, up to 20% of adult males have varicocele (1). Many scrotal masses are benign and require no treatment,... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
... READ EXCERPTS »
... Differential Overview
❑ Musculoligamentous strain
❑ Lumbar disc herniation
❑ Osteoarthritis
❑ Compression fracture ... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... In osteoporosis, a metabolic bone disorder, the rate of bone resorption accelerates while the rate of bone formation slows down, causing a loss of bone mass. Bones affected by this disease lose calcium and phosphate salts and thus become porous,... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... Two groups of neonates are born weighing less than the normal minimum birth weight of 51⁄2 lb (2,500 g)—those who are born prematurely (before 37 weeks' gestation) and those who are small for gestational age (SGA). Premature neonates weigh an... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
...
Nothing is more challenging to diagnose than a case of low back pain.
That is why it is so important to have an extensive list of causes in mind
before approaching the patient. Anatomy forms the basis for
developing such a list (Table 45)... Pictures
... READ EXCERPTS »
...
Aside from the common external hemorrhoids (which will not be seen in
many cases unless the patient is asked to bear down), anal masses may
include any of the following:
Skin tag ... Pictures
... READ EXCERPTS »
...
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... Pictures
... READ EXCERPTS »
...
When the clinician tries to recall the causes of a mass in the
extremities, he or she should consider the anatomy. As the clinician
dissects downward from the skin, he or she encounters the subcutaneous
tissue, veins, muscles, ligaments, bursae,... Pictures
... READ EXCERPTS »
...
To develop a list of possible causes of a face mass, let’s turn to
anatomy. The face is composed of skin, subcutaneous tissues, muscle, bone,
teeth, the sinuses, salivary glands, arteries, veins, and nerves. Applying the mnemonic VINDICATE
... READ EXCERPTS »
...
Most of these lesions are tumors, but because some are caused by other
etiologies, it is well to use the mnemonic MINT to review the
possibilities.
M—Malformations include dermoid cysts, ranula, Wharton duct cysts
or stones,
... READ EXCERPTS »
...
Because most orbital masses cause exophthalmos, the differential
diagnosis of the two is very similar (for illustration, see section on
exophthalmos, page 158). The best
method to use to arrive at the causes is to visualize the
... READ EXCERPTS »
...
Simply by thinking of the location of the pulsatile mass, one can
identify the cause or causes of a pulsatile mass.
Orbit. This is most likely an arteriovenous fistula related to
trauma or the spontaneous rupture of an
... READ EXCERPTS »
...
Masses of the skin may be better termed nodules if they are larger than
0.5 cm and are not just neoplastic in origin. The term VINDICATE
serves as a useful mnemonic to recall the important skin masses. When the
physician is... Pictures
... READ EXCERPTS »
...
In developing the differential diagnosis of an epigastric mass, one
merely needs to visualize the anatomy of the epigastrium from skin to spine.
The conditions are presented in outline form in Table 5, but the
important conditions are... Pictures
... READ EXCERPTS »
...
More physicians have been fooled by a hypogastric mass than by a mass
in any other area. How many times can you recall the mass disappearing on
the operating table after catheterization of the bladder? More often than
not, the mass is more apparent than... Pictures
... READ EXCERPTS »
...
The differential diagnosis of this symptom and sign is similar to that
of chest pain: Anatomy is the key to both. After visualizing all the
organs of the chest and cross-indexing them with the mnemonic MINT, a ... Pictures
... READ EXCERPTS »
...
When the clinician lays his or her hand on the RUQ and feels a mass, he
or she should visualize the anatomy and the differential diagnosis should
become clear. Proceeding from the skin, the physician encounters the
subcutaneous tissue, fascia,... Pictures
... READ EXCERPTS »
...
A localized mass on the head is usually a skin lesion, a lesion of the
bone, or a protrusion of intracranial tissue through the bone. An extensive
discussion of skin masses may be found on page 396, but most head masses originating from the skin are ... Pictures
... READ EXCERPTS »
...
Although anatomy may assist somewhat in developing the differential
here, it is probably an unnecessary exercise because the mnemonic
MINT will bring to mind virtually all the etiologies.
M—Malformation
... READ EXCERPTS »
... Author:
Renée Roberts, MD
What to Do - Make a Decision
The mediastinum is comprised of superior, anterior, middle, and posterior
compartments; however, masses in the anterosuperior compartment of children can be extremely unstable and challenging... Suggested Readings
... READ EXCERPTS »
... Charles Bailey, MD, PhDDon E. Eslin, MD, PhD (4th Edition) Mediastinal Mass - BASICS Mediastinal Mass - description Space-occupying lesion of the mediastinum: Anterior mediastinum includes the ... Mediastinal Mass - DIAGNOSIS ... Mediastinal Mass - TREATMENT ... Mediastinal Mass - FOLLOW UP ... Mediastinal Mass - bibliography ... Mediastinal Mass - CODES ... Mediastinal Mass - FAQ
... READ EXCERPTS »
The primary goal of osteoporosis treatment is to reduce the risk of fracture. Diet and exercise play an important role in treatment, but it's...
The connection between osteoporosis and low levels of calcium in the body is fairly well known by doctors and patients alike. But there are a number...
No one doubts that the skeleton is an essential part of the human body. But how many people understand how bone works, or how osteoporosis puts your...
Osteoporosis and osteoarthritis are distinct diseases which require very different treatments. But many of their symptoms are similar, which can lead...