Multiple Cutaneous Swellings Associated With Sudden Collapse Multiple Cutaneous Swellings and Sudden Collapse

Felton SJ, Ferguson JE. — Wed, 24 Oct 2012 00:00:00 GMT

A 77-year-old man presents with acute inability to walk. There is nohistory of trauma or back pain, and he has no bladder, bowel, or radicular symptoms. Medical history is significant only for benign prostatic hypertrophy. He takes no medication, has never smoked, drinks negligible alcohol, and prior to this episode was fully independent. On physical examination, the left lower extremity has reduced motor strength at 2/5 throughout, with depressed reflexes (2/4 knee and ankle jerks) and subjective, nondermatomal light-touch sensory loss. Plantar reflexes are down-going bilaterally. Right lower extremity strength and anal tone are normal, and there is no vertebral tenderness. Cardiac, pulmonary, and abdominal examination results are normal. There are multiple, tender, blue-black cutaneous swellings of up to 1-cm diameter across the upper torso/shoulders (Figure 1), which he says have been present for many years. He quickly deteriorates, developing profound bilateral leg weakness.

A Right Wrist Lump A Right Wrist Lump

De Rango P, Pagliuca V. — Wed, 14 Nov 2012 00:00:00 GMT

A 42-year-old male gardener presents with a 5-cm wrist mass causing functional limitation and swelling of the right hand. The mass has been present since the patient was 12 years old and has progressively enlarged. History is negative for any disease or trauma. At age 26 years the patient underwent orthopedic surgical exploration, but no specific diagnosis was confirmed. The mass is pale, nontender, cold, nonpulsatile, and soft to palpation. The remainder of a general physical examination is unremarkable. Magnetic resonance imaging was not explanatory. Color duplex ultrasonography of the mass shows a cystic appearance with no arterialized flow surrounding the cephalic vein. Angiography reveals persisting contrast enhancement with delayed x-ray fluoroscopy acquisition time at the right wrist level (Figure 1).

JAMA: Vascular Malformations Topic Collection

Multiple Cutaneous Swellings Associated With Sudden Collapse Multiple Cutaneous Swellings and Sudden Collapse

A Right Wrist Lump A Right Wrist Lump