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كتلة في زاوية الصدر


كتلة في زاوية الصدر


حالة سريرية

الوصف الكامل Background

جاءك صاحب الصورة أعلاه ، يشكو من كتلة مؤلمة في الزاوية العلوية اليمنى من الصدر.

الشكوى الرئيسية CC

قلق حيال الكتلة + ألم

القصة المرضية HPI

لديه تشوه في قوس الأبهر.

السوابق المرضية العائلية FMH

لا يوجد

الفحص السريري Clinical Exam

الوظائف الحركية للطرف المصاب طبيعية.

كتابة حرة وطرح موضوع النقاش!

ماذا تنظرون في هذه الحالة أيها الحكماء ؟

المرجع

e-medicine
Moore Oriented Anatomy

the prince of generation's picture
by
السنة السادسة

Quote:
what kind of aortic congenital malformation has he got?
Buzz_LightYear

Quote:
how does it feel on palpation?

MEDICAL REPORT:On physical examination, a mass-like lesion in the right clavicle

Quote:
for how long has he has it?

from birth...then it becomes bigger

Quote:
what kind of aortic congenital malformation has he got?

Anomalous right scbclavian artery
and the physician said it is not dangerous at all.
----
additional:
now he is six years old.

the prince of generation's picture
the prince of g...
السنة السادسة


وبعد أن صرع الولد راس الدكتور بالعياط... Evil
وبعد أن ترك الحكماء صغيرنا يزعوط في صفحات حكيم...... Twisted Evil
نتعو أبوه وأخدو على دكتور تاني Sad

the prince of generation's picture
the prince of g...
السنة السادسة


- كتلة منتفخة مؤلمة في منطقة الترقوة اليمنى.
- وهذه الكتلة موجودة منذ الولادة.
- وظائف الذراع الأيمن بالكامل سليمة.
هذا ملخص...ومن هو للسحور إذا ما صار شي رح نزل تقرير الحالة.

the prince of generation's picture
the prince of g...
السنة السادسة

physician asked for radiography:
Radiographic examination revealed a hypertrophic pseudarthrosis of the clavicle
because he was not sure if it is clvicle fracture (his parents didn't told him about any falling or any thing so)
so it is:Congenital Pseudoarthrosis of the Clavicle
-------
Sometimes fusion of the two ossification centers of the clavicle fails to occur; as a result, a bony defect forms between the lateral and the medial thirds of the clavicle. Awareness of this possible congenital defect should prevent diagnosis of a fracture in an otherwise normal clavicle. When doubt exists, both clavicles are radiographed because this defect is usually bilateral 'but it is singular in this case'
oriented anatomy
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Pathophysiology
Congenital pseudoarthrosis of the mid portion of the clavicle occurs when an environmental insult or anatomic or mechanical event disrupts diaphyseal membranous ossification. In congenital pseudoarthrosis of the clavicle, the 2 primary ossification centers fail to unite. The 2 portions of the clavicle produced are connected by a fibrous bridge that is contiguous with the periosteum, and a synovial membrane develops.2 The predominance of right-sided involvement in the absence of situs inversus suggests that the vascular anlage of the subclavian artery that crosses the first rib just below the pseudoarthrosis site may be involved in the etiology.

Congenital pseudoarthrosis has never been associated with malignant degeneration.

e-medicine
------
Presentation
A painless mass or swelling over the clavicle is the usual presenting concern. The patient has no history of trauma, and shoulder and arm movement are normal. A family history of similar deformities is rare.
------

but what about the treatment

the prince of generation's picture
the prince of g...
السنة السادسة

Medical Therapy
Mere observation may be appropriate. No nonoperative techniques achieve union.؟!

Surgical Therapy
Surgical intervention is indicated for pain, appearance that negatively impacts self-esteem, and shoulder deformity interfering with function

lifespring
السنة الخامسة


ربما الآن بسؤالي قد أتجاوز حدود المعلافة القاصرة جداً عندي...
ولكن فقط لإغناء الموضوع؟

what are the surgical solutions?
the prince of generation's picture
the prince of g...
السنة السادسة

Quote:
المعلافة

المعرفة
Embarrased

the prince of generation's picture
the prince of g...
السنة السادسة


this case is typical for:
اللهم أجرنا من علم لاينفع

Nostradamus
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