swelling in the leg

swelling in the leg

1. anatomy of the thigh

   • muscles
   • femur
     • ossification
       • proximal
         • shaft=7weeks in utero
         • femoral head=4-6months
         • greater trochanter=2-4 years
         • lesser trochanter=puberty
       • distal
         • 3-6 months
   • knee joint
     • anatomy
     • physiology
       • flexion
       • extension
       • slight medial and lateral rotations
     • restriction in the knee joint
       • cartilage injuries and disorders
       • ligament injuries
       • tendon injuries and disorders
     • physical examination
       • special tests
         • apley's grinding test
         • McMurray's test
         • patellar apprehension test
       • stability tests
         • anterior& posterior drawer tests
         • apley's distraction test
         • collateral ligament stress test
   • popliteal region
   • femoral artery

2. causes of leg pain and swelling

   • bone tumors
     • types
       • primary
         • benign
         • malignant
       • secondary (metastatic)
         • route
           • hematogenous
     • osteosarcoma
       • most common in teens and children
         • Males>females
       • site
         • metaphysics of long bones
       • management
         • above knee amputation
           • complications
             • phantom limb pain
             • wound healing
             • infections
             • wound breakdown
           • prognosis
             • removes diseased tissue
             • prevents spread of cancer
             • physiotherapy is needed
           • psychological effect
             • grief and PTSD
         • limb saving surgery
           • prognosis
             • cancer could develop again
             • better quality of life
           • complications
             • infections
             • might need more surgery
             • using internal prosthesis in growing children
         • chemotherapy
           • cisplatin
             • acts like an alkylating agents
           • doxorubicin
             • anticancer antibiotic
           • methotrexate
             • folic acid analog
       • complications
         • anemia
         • hematogenous spread
           • lung
           • prostate
           • breast
           • brain
       • radiologically
         • neo-osteogenesis
           • in subperiosteal layer
             • codman's traingle
           • from the central mass
             • sun burst appearance
         • radioisotope
           • used to indicate abnormal conditions
           • radioactive traces which emit gamma rays from within the body
       • skip lesions
         • tumors nodules growing within the same area of the tumor
       • prognosis
         • dependes on
           • response to treatment
           • age and general health
           • location and size of tumor
     • investgations
       • WBC count
         • to rule out inflammation and infection
       • hemoglobin test
       • ESR
         • test for anemia caused by cancer
       • chest radiograph
         • to check for metastasis
       • CT
       • MRI
     • histopathology
       • biopsy
         • needle
         • open
     • causes
       • inherited gene changes
       • radiation therapy
       • paget's disease
   • thigh strain\ injury
   • boil
   • diabetic muscle infarction
   • superficial thrombophlebitis

3. taking consent

   • a legal requirement and important for the discussion and decision making during the provision of health care servises
   • in case of a minor
     • the consent is taken fro a substitute giver

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