Swelling in the leg

Anatomy
1. bones
2. muscles
3. femoral artery
4. femoral vein
5. adductor canal
6. popliteal fossa
Possible causes of leg pain & swelling
1. diabetic muscle infarction
2. boil
3. thigh strain/ injury
4. superficial thrombophlebitis
5. tumors (bone tumors)
  1. most common bone tumors in children
    1. 2) Ewing's sarcoma
      1. children 10-15
      2. male>female
      3. site=diaphysis of long bones
      4. radiologically
      5. microscopically
    2. 1) Osteosarcoma
      1. male> female
      2. site:metaphysics of long bones
      3. histopathology
        1) pleomorphism & mitotic figures
        2) pink glassy homogenous osteoid formation
        3) fibroblastic and chondroblastic formation
        biopsy
        types
        needle
        open
      4. radiologically
        neo-osteogenesis
        in subperiosteal layer
        codman's triangle
        from the central mass
        sun burst appearance
      5. types
        primary
        children 12-14
        genetic mutation in p53 or retinoblastoma
        secondary
        adults >40
        post irradiation
      6. clinical picture
        pain, pathological fracture
        progressively growing mass
      7. stages of osteosarcoma
      8. investigations
        WBC count
        to rule out inflammation and infection
        hemoglobin test
        test for anaemia caused by cancer
        ESR
        to check for inflammation associated with cancer
      9. Management of osteosarcoma
        chemotherapy
        methotrexate
        folic acid analog
        inhibits dihydrofolate reductase
        thus inhibits DNA synthesis for replication of cells
        doxorubicin
        anticancer antibiotic
        several mechanisms of action
        causes DNA strand scission
        generate free radicals
        membrane disruption
        cisplatin
        acts like an alkylating agent
        cross links bases
        DNA strand breakage
        surgery
        amputation
        limb savage surgery
        autografts
        allografts
        rotatioplasty
        prosthetic implants
      10. Complications
        movement problems
        loss of a limb
        metastastis
        hematogenous spread
        liver
        lung
        brain
        bone
        chemotherapy side effects
        allopecia
        sterility
        GI complications
        Prognosis
        depends on
        age and general health
        location and size of tumor
        response to treatment
  2. benign
  3. melignant

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Swelling in the leg

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	Created by Salma Mk about 7 years ago