Subcutaneous soft tissue mass

Nowadays, many people often have subcutaneous soft tissue lumps. In fact, in this case, you need to check whether there is ulceration, swelling, pain, and rolling. This situation needs to be diagnosed in time. Be careful about the possibility of tumors or other phenomena. Because it does not grow on the outside of the skin, it is difficult to distinguish it by its shape. Only through reasonable examination can you know what problems are inside the skin.

Examination and diagnosis of soft tissue masses

Physical examination focus

First of all, we should pay attention to the local condition of the lump. If it is a local manifestation of a systemic disease, a detailed systemic examination should be performed.

(I) Mass examination

1. Visually examine the anatomical location, shape, size, surface skin color, and blood vessel filling around the mass, and check for redness, swelling, ulceration, fistula, pulsation, etc.

2. During palpation, pay attention to the precise location, shape, size, hardness, number, surface smoothness, and mobility of the lump (pay attention to whether there are adhesions around it, tenderness, fluctuation, and pulsation). Cystic masses are mostly round, hard, and solitary; malignant tumors often have adhesions, unclear surrounding boundaries, hard texture, fixed, and rough surface; inflammatory masses are red, swollen, hot, and carbuncle-like in the acute phase. A lump that does not disappear after the acute phase, such as chronic inflammation, should have a history of acute phase attacks. An aneurysm or arteriovenous fistula may be palpable with a pulsation or thrill.

3. Sometimes the lump is larger when percussed. By percussing, knowing whether it is a solid sound or a hollow sound will help determine its nature.

4. Auscultation is mainly to understand whether there are blood vessel pulsations or murmurs in the mass, especially for masses that are relatively soft or have a pulsating feeling, auscultation is more important. A systolic murmur may be heard in an aneurysm, and a continuous systolic and diastolic murmur may be heard in an arteriovenous fistula.

5. Characteristics of the tumor: Malignant tumors often have an uneven surface and are nodular. The texture is hard, and if it has penetrated into the surrounding area, it will be fixed and difficult to move. Generally there is no tenderness or mild tenderness: benign tumors have a smooth surface, clear boundaries, a medium hard or soft texture, are elastic and cystic, and have no tenderness. The acute inflammatory mass has unclear boundaries, is red and swollen on the surface, and has obvious tenderness locally. Chronic inflammatory masses such as tuberculosis only cause mild tenderness or no obvious tenderness.

The lumps vary in size and have a smooth surface. There is a certain range of motion, but no obvious symptoms. The lump is usually single. If there are multiple scattered lumps of varying sizes, benign lesions should be considered. If multiple lumps are adhered to each other, tuberculosis is likely to occur. If a soft tissue mass has obvious vascular pulsation and auscultation reveals vascular murmurs and pulsating sounds, it should be considered an aneurysm.