POPLITEAL SWELLING

Ask the Following Questions:

1. Is it soft or firm? A soft popliteal swelling may be an abscess, varicose vein, Baker's cyst, popliteal aneurysm, or swollen bursa. A firm popliteal swelling may be an osteosarcoma, periostitis, giant cell tumor, exostoses, lymphadenitis, lipoma, or fibroma.
2. If the mass is firm, is it connected to the bone? Masses that are connected to the bone are more likely exostoses, osteosarcomas, periostitis, or giant cell tumors. They may also be a subperiosteal hematoma.
3. Is there fever? The presence of fever with a popliteal swelling would suggest an acute abscess.
4. Is it reducible? If the popliteal swelling is reducible, a varicose vein is most likely.
5. Is there associated arthritis of the knee joint? The presence of associated arthritis of the knee joint suggests a Baker's cyst.
6. Is it pulsatile? If the mass is pulsatile, a popliteal aneurysm should be suspected.

DIAGNOSTIC WORKUP

Routine tests include a CBC, sedimentation rate, and x-ray of the knee. If these are negative, MRI or a CT scan of the knee may be ordered, and aspiration of the mass may be undertaken if the mass is not pulsatile or there is no bruit over the mass. However, it is more cost-effective to seek an orthopedic consultation before ordering these tests or undertaking aspiration of the swelling. If the mass is pulsatile, ultrasonography or angiography may be performed. If osteomyelitis is suspected, a bone scan will be helpful.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

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• Back to symptom: Swelling symptoms: Introduction (review 3250 causes)
• Next Book Extract About Swelling symptoms: PULSATILE SWELLING (Algorithmic Diagnosis of Symptoms and Signs)
• All Book Extracts: All Online Book Extracts for Swelling symptoms

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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