Soft, hemispherical, well-defined elastic mass on the lateral side of the leg

Introduction The anterior lateral part of the calf or the outside of the thigh has a mass. The mass of the mass is soft and hemispherical. The boundary is clear and has certain elasticity. When the muscle contracts, it disappears and becomes small. The oval and the sharp marginal fascia defect can be touched. Elastic masses with soft, hemispherical, and clear boundaries on the lateral side of the leg should be differentiated from varicose veins of the lower extremities, aneurysms, cold abscesses, ganglion cysts, and lipomas. In recent years, it has been suggested that tendon is a compensatory manifestation of chronic myofascial compartment syndrome. It has also been found that nearly half of patients with chronic calf muscle compartment syndrome have tendon.

Cause

Reasons for the soft, hemispherical, and clear elastic mass on the outside of the leg:

1. Myofascial defect or weakness:

Common causes of myofascial defects or weakness are as follows:

(1) Under normal circumstances, the muscle fascia has a normal, physiological defect or weak area. When the muscle pressure is increased, the muscle will be exuded. For example, the superficial peroneal nerve is descended from the lateral side of the sacral neck to the long and short muscles of the humerus, and the terminal branch passes through the fascia at the junction of the lower third of the calf to become a cutaneous branch, resulting in a partial defect. Or weak, the calf tendon can be pulled out. Muscles through the fascial nerve exit can cause nerve damage to jam, which in turn causes a series of symptoms.

(2) Surgical injury or sharp cutting can cause muscle damage and rupture of the fascia. For example, when the debridement is sutured, only the skin is sutured. When the muscle is swollen and the pressure is increased, it can bulge out of the fascia. For example, a blunt injury or fracture can damage the muscles and puncture the fascia, and the tendon is bulged out of the fascia due to muscle swelling and increased pressure.

(3) strenuous exercise or strong physical labor, uncoordinated movement or excessive load, and incorrect posture of the ground, unstable limbs and other factors, so that the muscles of the lower limbs are extremely contracted, resulting in damage to the muscle structure. Shrinking, the epicardium is longitudinally torn, forming a gap, so that the muscle bulges from the epicardial space, and the invagination, a small amount of oozing, secondary edema, exudation and other traumatic inflammatory reactions and peripheral muscles .

(4) Long-term chronic injury makes the lower limb fascia weak or ruptured.

(5) The fascia itself causes a weak fascia in a certain part.

2. Increased muscle pressure:

(1) After intense muscle exercise or excessive activity, local metabolism is enhanced, blood oxygen concentration decreases metabolite accumulation, microcirculation exudation increases, interstitial fluid increases, muscles may swell and hypertrophy; however, fascial wall limits hypertrophy The expansion of the muscles increases the pressure in the muscle compartment, which in turn causes the muscles to protrude from the weak or defective areas to form tendons.

(2) The wounds, surgery or muscles themselves can cause muscle swelling, increased pressure, and bulge from the weak or fascia of the fascia to form tendons.

an examination

Related inspection

Blood routine four-step palpation

Examination and diagnosis of soft, hemispherical, and clear elastic masses on the outside of the leg:

1. Most patients have a history of trauma.

2. The anterior lateral part of the calf or the outer side of the thigh has a mass. The mass of the mass is soft and hemispherical, and the boundary has a certain elasticity. When the muscle contracts, it disappears and becomes small, and the oval and the sharp edge fascia defect can be touched.

3. Diagnostic puncture is negative.

4. Ultrasonography can assist in clinical diagnosis.

Differential diagnosis

Differential diagnosis of soft, hemispherical, and clear elastic masses on the outside of the leg:

1. Varicose veins of the lower extremities, aneurysms: multiple tendons need to be differentiated from varicose veins of the lower extremities, aneurysms, etc., and the varicose veins of the lower extremities are not related to trauma. The lower extremity masses become smaller or disappear, and the diagnostic puncture can identify the aneurysms with waves. Dynamic audible audible murmurs.

2. Cold abscess: patients with cold abscess often have a history of tuberculosis with a sense of fluctuation and can be identified.

3. ganglion cyst: occurs in the tendon and tendon sheath, the muscle does not shrink or disappear when contracted, can be identified.

4. Lipoma: The mass of the tumor is subcutaneous, soft and lobulated, and the activity does not change with the muscle activity becoming smaller or disappearing.

5. Others: In addition, it needs to be differentiated from muscle tear and tendon rupture hemangioma.

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