Hi Everyone I was wondering if I could get your thoughts on a patient of mine..
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History
24 year old male
Healthy.. no underlying health issues
has a palpable mass on the medial aspect of the first MTPJ present for 4 -5 years
no history of trauma
sensitive when objects brush against it not so much when applied with perpendicular pressure
Footwear is unremarkable.. not tight at lesion site
doesn't participate in regular sporting activities
sent for Ultrasound which showed:
a heterogeneous thickening of the subcutaneous tissue that is mainly hypo echoic. the area is not vascular.
measures approx 1.0 x0.36 x 1.9cm in dimensions
no evidence of joint effusion
My thoughts are
1) since being mainly fluid, it should be aspirational ?( new word Palin style) lol
2) since the area is not vascular it would be potentially clean without blood and with potentially less pain?
3) would it be reasonable to burst the lesion and let the contents be absorbed by surrounding tissue?
4) or would it be a better idea to try and decrease size of the lesion by aspirating as much fluid as possible? guage size?
he is interested in trying something to treat the lesion
Hope i haven't missed anything
Steve
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