Soft tissue abscess the clinical evaluation

Male 65 y/o, he complains pain and swelling in left groin, he has history of hypertension. He has not fever. Clinical examination shows swelling, skin is hot and eritematous.








Is it an abscess, a cellulitis or something else?

 

Conclusion 

Differentiating a soft tissue abscess from cellulitis is important because each disorder requires a different treatment.

Clinical examination alone has small role for this scope.

May we need something else?

Bibliography 

BT Squire, JC Fox, C Anderson

ABSCESS: Applied Bedside Sonography for Convenient Evaluation of Superficial Soft Tissue Infections

ACAD EMERG MED July 2005, Vol. 12, No. 7 

To be continued...

Ciro Paolillo

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Acute appendicitis and signs

A 21 y/o man presents to the ED with pain in right low quadrant (RLQ) , anorexia, nausea and vomiting. His abdomen is soft, with a mild tenderness in RLQ, the psoas sign is positive. The pain is aggravate by cough. You perform kindly a rectal examination with pain. 

Are this signs useful for the diagnosis of acute appendicitis?

Conclusion 

No clinical signs alone is able to rule in or out an acute appendicitis. Rectal examination, still diffused, is not of any utility. 

May we need somwthing else?

Bibliography 

Meta-analysis of the clinical and laboratory diagnosis of appendicitis

British Journal of Surgery 2004; 91: 28-37

R.E.B. Anderson

Ciro Paolillo

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