What are the common causes of lumps on the wrist or hand. How can you identify different types of hand lumps. When should you seek medical attention for a wrist lump. What are the treatment options for various hand and wrist lumps.

Common Types of Wrist and Hand Lumps

Lumps on the wrist or hand can be concerning, but they’re often benign and treatable. Understanding the various types of lumps can help you determine when to seek medical attention. Here are some of the most common causes:

Ganglion Cysts

Ganglion cysts are non-cancerous, fluid-filled lumps that typically develop on the back of the wrist or on the hand. They’re usually round or oval-shaped and can vary in size. Are ganglion cysts painful? While often painless, they may cause discomfort if they press on a nerve, potentially leading to pain, numbness, or muscle weakness in the affected area.

How do ganglion cysts form? These cysts grow out of the tissues surrounding a joint or tendon sheath. They can appear and disappear quickly, and their size may fluctuate over time. To prevent ganglion cysts from growing larger, it’s advisable to limit stress on your wrist. In most cases, these cysts will resolve on their own without intervention.

Giant Cell Tumor of the Tendon Sheath (GCTTS)

GCTTS is the second most common benign tumor in the hand after ganglion cysts. These slow-growing tumors develop in the tendon sheath, which is the membrane surrounding a tendon that aids in smooth movement. Are GCTTS painful? Typically, these lumps are not painful and form slowly over time.

Epidermal Inclusion Cysts

Epidermal inclusion cysts are benign lumps that form just under the skin. They’re filled with keratin, a yellow, waxy substance. What causes epidermal inclusion cysts? They often result from skin irritation or injury to hair follicles. These cysts may remain stable in size or grow larger over time.

Can epidermal inclusion cysts become problematic? In some cases, they may become inflamed or infected, leading to pain and redness. To alleviate discomfort, you can apply a warm, moist cloth to the affected area. It’s important to avoid poking or squeezing the cyst, as this can exacerbate the condition.

Rare but Serious Wrist and Hand Lumps

While most wrist and hand lumps are benign, it’s crucial to be aware of potentially serious conditions that may require prompt medical attention.

Malignant Tumors

Although rare, some lumps in the wrist and hand can be cancerous. How can you identify a potentially malignant tumor? Malignant tumors often grow quickly and may have an irregular shape. They can be painful, especially at night. These tumors may manifest as skin lesions or fast-growing lumps under the skin.

What types of cancer can affect the hand and wrist? Several types of cancer can occur in this area, including:

• Skin cancers (e.g., melanoma and squamous cell carcinoma)
• Various sarcomas (e.g., liposarcomas and rhabdomyosarcomas)

Other Less Common Tumors

There are several other types of tumors that can develop in the wrist or hand, although they are generally benign. These include:

• Lipomas (fatty tumors)
• Neuromas (nerve tumors)
• Fibromas (tumors of the connective tissue)
• Glomus tumors (typically found around the nail or fingertip)

Arthritis-Related Lumps in the Hand and Wrist

Various forms of arthritis can cause lumps or nodules to form in the hand and wrist area. Understanding these conditions can help in early detection and management.

Osteoarthritis

Osteoarthritis occurs when the cartilage cushioning your joints begins to wear down. How does osteoarthritis affect the hands? In the hands, it can lead to the formation of small, bony lumps or knobs on the finger joints. These lumps are often accompanied by stiffness, swelling, and pain.

Rheumatoid Arthritis (RA)

Rheumatoid arthritis is an autoimmune disease that causes your immune system to attack your joints, leading to inflammation, tissue damage, and potential deformities. What are rheumatoid nodules? About 25 percent of people with RA develop rheumatoid nodules, which are firm, round or linear lumps that form under the skin. These nodules typically develop near joints that undergo repeated pressure or stress, such as those in the forearm and fingers.

Gout

Gout is a type of arthritis characterized by the formation of crystals in the joints, causing redness, pain, and swelling. While gout most commonly affects the feet, it can also impact the wrist and fingers. How do gout crystals form? They develop when your body produces excess uric acid or fails to eliminate it efficiently.

Can gout cause visible lumps? In some cases, gout crystals can form bumps under the skin called tophi. These white-colored lumps are typically painless but can indicate advanced gout.

Other Causes of Wrist and Hand Lumps

Several other conditions can lead to the formation of lumps in the wrist and hand area. Being aware of these can help in proper identification and treatment.

Foreign Bodies

Sometimes, foreign objects such as wooden splinters or glass fragments can become lodged in your hand. If not removed, these can lead to a reaction involving swelling, a visible lump, and pain. How can you identify a foreign body reaction? The area may be tender to touch, and you might notice redness or warmth around the lump.

Carpal Boss

A carpal boss is an overgrowth of bone at the wrist. It appears as a hard bump on the back of the wrist and is sometimes mistaken for a ganglion cyst. Does a carpal boss cause pain? Carpal bosses can cause pain similar to arthritis, which may worsen with increased activity. Resting and limiting movement of the affected wrist can help alleviate discomfort.

Trigger Finger

Trigger finger affects the flexor tendons of your hand, causing the affected finger to lock or catch when you bend it. While not a lump per se, it can cause a noticeable thickening or nodule in the palm at the base of the affected finger. How does trigger finger develop? It results from inflammation of the tendon sheath, causing the tendon to catch as it moves through the sheath.

Diagnosis and Treatment of Wrist and Hand Lumps

Proper diagnosis is crucial for effective treatment of wrist and hand lumps. Here’s an overview of the diagnostic process and common treatment options:

Diagnostic Procedures

When you consult a healthcare provider about a lump on your wrist or hand, they may perform several diagnostic procedures:

• Physical examination: The doctor will visually inspect and palpate the lump, checking for size, consistency, and tenderness.
• Medical history: They’ll ask about your symptoms, how long you’ve had the lump, and any relevant medical conditions.
• Imaging tests: X-rays, ultrasounds, or MRI scans may be ordered to get a detailed view of the lump and surrounding structures.
• Biopsy: In some cases, a small sample of the lump may be taken for laboratory analysis to rule out malignancy.

Treatment Options

Treatment for wrist and hand lumps varies depending on the underlying cause. Here are some common approaches:

1. Observation: Many benign lumps, such as ganglion cysts, may resolve on their own and only require monitoring.
2. Medications: Anti-inflammatory drugs or corticosteroids may be prescribed to reduce pain and swelling.
3. Aspiration: For fluid-filled cysts, the doctor may use a needle to drain the fluid.
4. Surgery: Surgical removal may be necessary for persistent or problematic lumps.
5. Physical therapy: This can help improve joint function and reduce pain in cases related to arthritis or overuse injuries.
6. Lifestyle modifications: Adjusting activities or using supportive devices may help manage symptoms.

When to Seek Medical Attention for Wrist and Hand Lumps

While many wrist and hand lumps are harmless, certain symptoms warrant prompt medical evaluation. You should consult a healthcare provider if you experience:

• Rapid growth of the lump
• Severe or persistent pain
• Changes in skin color or texture over the lump
• Impaired hand or wrist function
• Signs of infection, such as redness, warmth, or fever
• Any lump that doesn’t resolve within a few weeks

Early detection and treatment can prevent complications and ensure the best possible outcome.

Prevention and Self-Care for Wrist and Hand Health

While not all wrist and hand lumps are preventable, there are steps you can take to maintain the overall health of your hands and wrists:

Ergonomic Practices

Proper ergonomics can help prevent conditions like carpal tunnel syndrome and reduce stress on your wrists and hands. How can you improve your ergonomics?

• Use ergonomic keyboards and mouse devices
• Maintain good posture while working
• Take regular breaks to stretch and rest your hands and wrists
• Adjust your workstation to promote neutral wrist positions

Hand Exercises

Regular hand and wrist exercises can help maintain flexibility and strength. What are some beneficial exercises for hand health?

• Wrist flexion and extension stretches
• Finger touches (touching each finger to your thumb)
• Making a fist and then spreading your fingers wide
• Wrist rotations

Perform these exercises gently and stop if you experience pain.

Protective Measures

Taking steps to protect your hands and wrists can prevent injuries that might lead to lump formation. How can you protect your hands?

• Wear gloves when doing manual work or using chemicals
• Use proper techniques when lifting heavy objects
• Avoid overuse of your hands and wrists in repetitive tasks
• Use wrist guards during activities like skating or snowboarding

Nutritional Support

A balanced diet rich in certain nutrients can support joint health. Which nutrients are beneficial for hand and wrist health?

• Omega-3 fatty acids: Found in fish, flaxseeds, and walnuts, these can help reduce inflammation
• Vitamin C: Important for collagen production, found in citrus fruits, berries, and leafy greens
• Vitamin D and calcium: Essential for bone health, found in dairy products, fortified foods, and through sun exposure (for vitamin D)
• Antioxidants: Found in colorful fruits and vegetables, these can help protect against cellular damage

By incorporating these preventive measures and self-care practices into your daily routine, you can promote the health of your hands and wrists and potentially reduce the risk of developing certain types of lumps or other hand-related issues.

Lumps on Your Wrist or Hand: Causes and Treatment

Most of the time, lumps on your wrist or hand aren’t serious. In rare cases, a lump can be a sign of a condition that may require prompt medical attention. Below, we’ll take a deeper dive into what can cause these lumps.

Ganglion cyst

A ganglion cyst is a non-cancerous (benign) lump that occurs around joints. They commonly develop on the back of the wrist or on the hand, and are often round or oval-shaped.

Ganglion cysts grow out of the tissues surrounding a joint or a tendon sheath and are filled with fluid. They can appear and disappear quickly and can also change size.

Ganglion cysts are often painless. However, if they begin to press on a nerve, you may experience pain, numbness, or muscle weakness in the area. You should try to limit the amount of stress placed on your wrist, as using your wrist too much can potentially cause the cyst to get bigger.

Most ganglion cysts will eventually go away on their own.

Giant cell tumor of the tendon sheath (GCTTS)

GCTTS are a type of benign tumor, which means it is non-cancerous and won’t spread to other parts of the body. After the ganglion cyst, they’re the second most common benign tumor in the hand.

GCTTS are slow-growing tumors and form lumps that are typically not painful. They develop in the tendon sheath, which is the membrane that surrounds a tendon in your hand and helps it to move smoothly.

Epidermal inclusion cyst

Epidermal inclusion cysts are benign lumps that develop just under your skin. They’re filled with a yellow, waxy material that’s called keratin. They can sometimes form due to irritation or injury to the skin or hair follicles.

Epidermal inclusion cysts can remain the same size or get bigger over time. In some cases, they may also become inflamed or even infected. When this happens, they can become painful and red.

You can help to relieve discomfort by applying a warm, moist cloth to the cyst. Avoid poking or squeezing the cyst.

Malignant tumors

Most cysts and tumors found in the wrist and hand are benign. However, in rare cases, some can be cancerous.

A malignant tumor tends to grow quickly and can be irregular in shape. They can also be painful, especially at night. These tumors can develop as lesions on the skin (abnormal skin appearance or growth) or as fast-growing lumps under the skin.

There are several different types of cancers that can affect the hand and wrist. These can include skin cancers, like melanoma and squamous cell carcinoma and various sarcomas like liposarcomas and rhabdomyosarcomas.

Other types of tumors

In addition to those mentioned above, there are also some less common tumors or cysts that may form in the wrist or hand. They’re almost always benign and can include:

• lipomas (fatty tumors)
• neuromas (nerve tumors)
• fibromas (tumors of the connective tissue)
• glomus tumors, found around the nail or fingertip

Osteoarthritis

Osteoarthritis happens when the cartilage that cushions your joints begins to wear down. This can lead to pain and swelling in the joints.

When arthritis occurs in your hands, you may notice small, bony lumps or knobs on the joints of your fingers. This may be accompanied by stiffness, swelling, and pain.

Rheumatoid arthritis (RA)

Rheumatoid arthritis (RA) is an autoimmune disease in which your immune system attacks your joints. This can leading to inflammation, tissue damage, and deformities.

About 25 percent of people with RA have rheumatoid nodules. These are lumps that develop under your skin. They can be round or linear and are firm to the touch, but typically aren’t tender.

Rheumatoid nodules usually develop close to joints that undergo repeated pressure or stress. They can occur in many areas of the body, including the forearm and fingers.

Gout

Gout is a type of arthritis in which crystals form in your joints. This can lead to redness, pain, and swelling. Gout can affect the wrist and fingers, although it is most common in the joints of the feet.

Gout crystals form when your body makes too much of, or doesn’t get rid of, a chemical called uric acid. Sometimes gout crystals can form bumps under the skin called tophi. These are white in color and aren’t painful.

Foreign body

Sometimes a foreign object such as a wooden splinter or a glass fragment can get stuck in your hand. If the foreign body isn’t removed, a reaction may develop that involves swelling, a visible lump, and pain.

Carpal boss

A carpal boss is an overgrowth of bone at your wrist. You may notice a hard bump on the back of your wrist. Sometimes, a carpal boss is mistaken for a ganglion cyst.

Carpal bosses can cause pain similar to that of arthritis. This pain can get worse with increased activity. You can help to relieve it by resting and limiting movement of the affected wrist.

Trigger finger

Trigger finger affects the flexor tendons of your hand, causing them to become swollen. When this happens, the tendon on the palm side in your finger can catch on the tendon sheath, making it hard to move the affected finger.

Sometimes a small lump can form at the base of the affected finger as well. The presence of this lump can lead to further catching of the tendon, causing your finger to get stuck in the bent position.

Dupuytren’s contracture

Dupuyren’s contracture happens when the tissue in the palm of your hand thickens. It can also affect your fingers.

If you have Dupuytren’s contracture, you may notice pits and firm lumps on the palm of your hand. While the lumps aren’t typically painful, they may feel uncomfortable.

Thick cords of tissue can also develop from the palm and into the finger. This can cause the affected fingers to bend inward.

If you notice a lump on your wrist or hand, it’s a good idea to make an appointment with your doctor. They can evaluate the lump and help you get the treatment you may need.

Be sure to get medical attention for any lump that:

• has grown rapidly
• is painful
• comes with symptoms such as numbness, tingling, or muscle weakness
• appears infected
• is in a location that’s easily irritated

If you need help connecting with a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.

In order to diagnose the cause of your lump, your doctor will first take your medical history. They’ll ask you things like when you first noticed the lump, whether it has changed in size, and if you’re experiencing any symptoms.

• Physical examination. Your doctor will examine your lump. They may press on the lump to check for pain or tenderness. They may also shine a light on the lump to help them see if it’s solid or filled with fluid.
• Imaging. Your doctor may also want to use imaging technology to get a better view of the lump and the surrounding tissue. This can include things like an ultrasound, MRI, or X-ray.
• Biopsy. In the case of a cyst or tumor, your doctor may want to take a tissue sample to examine the cells.
• Laboratory tests. Blood tests can help diagnose some conditions like RA and gout.

The treatment for your wrist or hand lump can depend on the condition that’s causing it. Your doctor will work to come up with a treatment plan that’s right for you. Possible treatments can include:

• Over-the-counter (OTC) medications. You may be able to use OTC medications to relieve pain and inflammation. Common OTC drugs include acetaminophen (Tylenol), ibuprofen (Motrin, Advil), and naproxen (Aleve).
• Prescription medications. Sometimes your doctor may prescribe a medication like oral or injected corticosteroids or specialized medications for conditions like RA.
• Immobilization. A splint or brace can be used to immobilize your wrist or hand. This may be used when movement causes pain or causes a cyst or tumor to get larger.
• Aspiration. In some cases, the fluid in a lump may need to be drained using a needle. This may be done for ganglion cysts and epidermal inclusions.
• Physical therapy. This can include exercises to help increase your range of motion and improve strength in your hands or wrist. Physical therapy can be particularly helpful for osteoarthritis, RA, or while recovering from surgery.
• Surgery. Your doctor may choose to remove the lump surgically. This may be done for a variety of conditions, including ganglion cysts and other types of cysts or tumors. Also, conditions that cause lumps, such as trigger finger and carpal boss, may also be treated surgically.
• Cancer therapies. When a tumor is malignant, the most common types of treatment include surgery, radiation therapy and chemotherapy.

Most of the time, lumps on your hand or wrist aren’t a cause for concern. But, in rare cases, they may be a sign of a more serious condition.

It’s important to follow up with your doctor if you notice a lump that’s grown quickly, is painful, or is accompanied by other symptoms like numbness or tingling. Your doctor will work with you to develop a treatment plan that’s appropriate for your condition.

If you don’t already have a primary care provider, you can browse doctors in your area through the Healthline FindCare tool.

Lumps on Your Wrist or Hand: Causes and Treatment

Most of the time, lumps on your wrist or hand aren’t serious. In rare cases, a lump can be a sign of a condition that may require prompt medical attention. Below, we’ll take a deeper dive into what can cause these lumps.

Ganglion cyst

A ganglion cyst is a non-cancerous (benign) lump that occurs around joints. They commonly develop on the back of the wrist or on the hand, and are often round or oval-shaped.

Ganglion cysts grow out of the tissues surrounding a joint or a tendon sheath and are filled with fluid. They can appear and disappear quickly and can also change size.

Ganglion cysts are often painless. However, if they begin to press on a nerve, you may experience pain, numbness, or muscle weakness in the area. You should try to limit the amount of stress placed on your wrist, as using your wrist too much can potentially cause the cyst to get bigger.

Most ganglion cysts will eventually go away on their own.

Giant cell tumor of the tendon sheath (GCTTS)

GCTTS are a type of benign tumor, which means it is non-cancerous and won’t spread to other parts of the body. After the ganglion cyst, they’re the second most common benign tumor in the hand.

GCTTS are slow-growing tumors and form lumps that are typically not painful. They develop in the tendon sheath, which is the membrane that surrounds a tendon in your hand and helps it to move smoothly.

Epidermal inclusion cyst

Epidermal inclusion cysts are benign lumps that develop just under your skin. They’re filled with a yellow, waxy material that’s called keratin. They can sometimes form due to irritation or injury to the skin or hair follicles.

Epidermal inclusion cysts can remain the same size or get bigger over time. In some cases, they may also become inflamed or even infected. When this happens, they can become painful and red.

You can help to relieve discomfort by applying a warm, moist cloth to the cyst. Avoid poking or squeezing the cyst.

Malignant tumors

Most cysts and tumors found in the wrist and hand are benign. However, in rare cases, some can be cancerous.

A malignant tumor tends to grow quickly and can be irregular in shape. They can also be painful, especially at night. These tumors can develop as lesions on the skin (abnormal skin appearance or growth) or as fast-growing lumps under the skin.

There are several different types of cancers that can affect the hand and wrist. These can include skin cancers, like melanoma and squamous cell carcinoma and various sarcomas like liposarcomas and rhabdomyosarcomas.

Other types of tumors

In addition to those mentioned above, there are also some less common tumors or cysts that may form in the wrist or hand. They’re almost always benign and can include:

• lipomas (fatty tumors)
• neuromas (nerve tumors)
• fibromas (tumors of the connective tissue)
• glomus tumors, found around the nail or fingertip

Osteoarthritis

Osteoarthritis happens when the cartilage that cushions your joints begins to wear down. This can lead to pain and swelling in the joints.

When arthritis occurs in your hands, you may notice small, bony lumps or knobs on the joints of your fingers. This may be accompanied by stiffness, swelling, and pain.

Rheumatoid arthritis (RA)

Rheumatoid arthritis (RA) is an autoimmune disease in which your immune system attacks your joints. This can leading to inflammation, tissue damage, and deformities.

About 25 percent of people with RA have rheumatoid nodules. These are lumps that develop under your skin. They can be round or linear and are firm to the touch, but typically aren’t tender.

Rheumatoid nodules usually develop close to joints that undergo repeated pressure or stress. They can occur in many areas of the body, including the forearm and fingers.

Gout

Gout is a type of arthritis in which crystals form in your joints. This can lead to redness, pain, and swelling. Gout can affect the wrist and fingers, although it is most common in the joints of the feet.

Gout crystals form when your body makes too much of, or doesn’t get rid of, a chemical called uric acid. Sometimes gout crystals can form bumps under the skin called tophi. These are white in color and aren’t painful.

Foreign body

Sometimes a foreign object such as a wooden splinter or a glass fragment can get stuck in your hand. If the foreign body isn’t removed, a reaction may develop that involves swelling, a visible lump, and pain.

Carpal boss

A carpal boss is an overgrowth of bone at your wrist. You may notice a hard bump on the back of your wrist. Sometimes, a carpal boss is mistaken for a ganglion cyst.

Carpal bosses can cause pain similar to that of arthritis. This pain can get worse with increased activity. You can help to relieve it by resting and limiting movement of the affected wrist.

Trigger finger

Trigger finger affects the flexor tendons of your hand, causing them to become swollen. When this happens, the tendon on the palm side in your finger can catch on the tendon sheath, making it hard to move the affected finger.

Sometimes a small lump can form at the base of the affected finger as well. The presence of this lump can lead to further catching of the tendon, causing your finger to get stuck in the bent position.

Dupuytren’s contracture

Dupuyren’s contracture happens when the tissue in the palm of your hand thickens. It can also affect your fingers.

If you have Dupuytren’s contracture, you may notice pits and firm lumps on the palm of your hand. While the lumps aren’t typically painful, they may feel uncomfortable.

Thick cords of tissue can also develop from the palm and into the finger. This can cause the affected fingers to bend inward.

If you notice a lump on your wrist or hand, it’s a good idea to make an appointment with your doctor. They can evaluate the lump and help you get the treatment you may need.

Be sure to get medical attention for any lump that:

• has grown rapidly
• is painful
• comes with symptoms such as numbness, tingling, or muscle weakness
• appears infected
• is in a location that’s easily irritated

If you need help connecting with a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.

In order to diagnose the cause of your lump, your doctor will first take your medical history. They’ll ask you things like when you first noticed the lump, whether it has changed in size, and if you’re experiencing any symptoms.

• Physical examination. Your doctor will examine your lump. They may press on the lump to check for pain or tenderness. They may also shine a light on the lump to help them see if it’s solid or filled with fluid.
• Imaging. Your doctor may also want to use imaging technology to get a better view of the lump and the surrounding tissue. This can include things like an ultrasound, MRI, or X-ray.
• Biopsy. In the case of a cyst or tumor, your doctor may want to take a tissue sample to examine the cells.
• Laboratory tests. Blood tests can help diagnose some conditions like RA and gout.

The treatment for your wrist or hand lump can depend on the condition that’s causing it. Your doctor will work to come up with a treatment plan that’s right for you. Possible treatments can include:

• Over-the-counter (OTC) medications. You may be able to use OTC medications to relieve pain and inflammation. Common OTC drugs include acetaminophen (Tylenol), ibuprofen (Motrin, Advil), and naproxen (Aleve).
• Prescription medications. Sometimes your doctor may prescribe a medication like oral or injected corticosteroids or specialized medications for conditions like RA.
• Immobilization. A splint or brace can be used to immobilize your wrist or hand. This may be used when movement causes pain or causes a cyst or tumor to get larger.
• Aspiration. In some cases, the fluid in a lump may need to be drained using a needle. This may be done for ganglion cysts and epidermal inclusions.
• Physical therapy. This can include exercises to help increase your range of motion and improve strength in your hands or wrist. Physical therapy can be particularly helpful for osteoarthritis, RA, or while recovering from surgery.
• Surgery. Your doctor may choose to remove the lump surgically. This may be done for a variety of conditions, including ganglion cysts and other types of cysts or tumors. Also, conditions that cause lumps, such as trigger finger and carpal boss, may also be treated surgically.
• Cancer therapies. When a tumor is malignant, the most common types of treatment include surgery, radiation therapy and chemotherapy.

Most of the time, lumps on your hand or wrist aren’t a cause for concern. But, in rare cases, they may be a sign of a more serious condition.

It’s important to follow up with your doctor if you notice a lump that’s grown quickly, is painful, or is accompanied by other symptoms like numbness or tingling. Your doctor will work with you to develop a treatment plan that’s appropriate for your condition.

If you don’t already have a primary care provider, you can browse doctors in your area through the Healthline FindCare tool.

ultrasound of the elbow lymph nodes in St. Petersburg – the price is 1200 rubles in the center of ultrasound diagnostics “Affordable Medicine”

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1,900 rubles

Price:

1,200 rubles

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• Prices
• Description
• Addresses

• Execution time
  30 minutes

Description

Elbow lymph nodes are located in the soft tissues just above the cubital fossa and closer to the body. They collect and filter lymph from the hand and forearm. Normally, they are not always found on palpation. However, they increase with inflammation of the underlying tissues, for example, with cat scratch disease, which most often affects the hands. Malignant neoplasms of the skin in the forearm also lead to an increase in the elbow lymph nodes. With lymphomas, the lymph nodes of several groups increase at once.

Indications for ultrasound of the ulnar lymph nodes

A doctor – a general practitioner, surgeon, dermatologist, infectious disease specialist or okonologist – will refer the patient for an ultrasound scan if the following signs are present:

There is a fever, signs of intoxication.

What can be seen on an ultrasound

Diagnosis of enlarged elbow lymph nodes shows how they have changed compared to the norm:

• More rounded;
• Increased in size;
• The membrane has thickened or, conversely, has grown into adjacent tissues;
• The internal substance changed its echogenicity, more or less dense areas appeared;
• Changed the nature of the feeding blood vessels.

Ultrasound allows you to determine the cause of an enlarged lymph node: benign or malignant growth, cyst, hyperplasia.

Preparation for ultrasound of the elbow lymph nodes

No specific preparation is required for the procedure. The patient frees his elbows from clothing and sits on a chair. The doctor places the transducer on the skin in the area of ​​interest and looks at the nodes on the screen. For comparison, the diagnosis is carried out on a healthy hand. Together with filling out the study protocol, the procedure takes about 15-20 minutes.

Contraindications for ultrasound of the elbow lymph nodes

Ultrasound is non-invasive and does not carry radiation exposure, therefore it is allowed for everyone.

Prices

Addresses of diagnostic centers “Affordable Medicine”

St. Petersburg, m. Vosstaniya Square, st. 1st Sovetskaya, 8

How to get there?

Saint-Petersburg, m. Narvskaya, Stachek Square, 9

How to get there?

Saint-Petersburg, m.

+7 (812) 380-83-84
[email protected]

Onco Wiki – Sentinel Node Biopsy

The sentinel, or sentinel, lymph node is the first on the path of lymph outflow from the tumor. Tumor cells can be carried by lymph along the lymphatic vessels from the primary tumor to the lymph nodes.

Biopsy of the sentinel (sentinel) lymph node is a diagnostic operation to detect micrometastases. It is impossible to see them on CT or ultrasound due to the limitations of the resolution of these methods.). Metastases in the form of individual cells can only be detected by a pathologist by examining sections of a removed lymph node under a microscope.

SLNB is carried out in three stages:

– determination of the location of sentinel lymph nodes,

– surgical removal of them,

– search under a microscope for tumor cells in the tissue of the lymph nodes.

The presence or absence of micrometastases in the sentinel lymph node determines the stage of skin melanoma. The tactics of patient management depend on this.

Indications for SLNB in ​​confirmed skin melanoma:

• peripheral lymph nodes not affected by metastases,
• no distant metastases,
• Tumor more than 0. 8 mm thick or less than 0.8 mm thick with ulceration, aggressive tumor at a young age – at any size.

Hospitalization usually required for 3-4 days.

At the first stage, 4-8 injections are made into the skin around the tumor or scar left after its removal. A radiopharmaceutical (RFP) is administered. Its molecules, labeled with technetium-99, get from the skin into the lymphatic ducts, through them to the lymph nodes and linger there. The radiopharmaceutical repeats the path of potential metastases from the primary tumor and accumulates in the first oncoming one – the sentinel lymph node.

Lymphoscintigraphy and single photon emission computed tomography (SPECT) with X-ray computed tomography (SPECT-CT) after the introduction of radiopharmaceuticals make it possible to make visible the course of the lymphatic vessels and lymph nodes with drug accumulation. These methods capture the radiation of a radioactive substance and display an image on the screen.

A mark is made on the patient’s skin at the location of the sentinel lymph node or several. There may be more than one. Depending on the location of the primary tumor, lymph can flow in many directions at once. With melanoma on the arm, the sentinel lymph node is more likely to be in the nearest axillary region. If melanoma is on the leg – in the nearest inguinal and / or popliteal region. However, when melanoma is located on the back or abdomen, the lymph from it can move both to the axillary and to the inguinal lymph nodes. And sometimes in all 4 directions at once: both axillary and both inguinal regions. In this case, SLNB can be performed in several areas of the lymph flow at once.

It is important that the accumulation of radiopharmaceuticals in a lymph node does not mean that it is affected by metastases. Only designates the place where they are most likely to be found, if any.

Taking into account the characteristics of the radiopharmaceutical, the operation is performed on the day of its introduction or the next day.

The operation is performed under anesthesia. On the day of the operation, the patient should refrain from eating and drinking to avoid reflux of stomach contents into the respiratory tract during anesthesia.

On the operating table, the position of the sentinel lymph nodes that have accumulated radiopharmaceuticals in the already marked places is clarified using a gamma detector. The device shows the level of radiopharmaceutical accumulation on the screen or by sound signals.

The skin is incised over the area of ​​the sentinel lymph node. A gamma detector is inserted into the wound to accurately identify the sentinel lymph node. The node is removed. The wound is checked with a gamma detector for the presence of other sentinel lymph nodes. There may be several of them even in one closest group of lymph nodes.

Removed nodes are sent to the pathology department for histological examination.

Major but fairly rare (average complication rate 3-8%) complications of SLNB:

– impaired sensitivity at the operation site – numbness of the skin,

– soreness in the area of ​​the postoperative wound,

– formation of a hematoma – bruise,

– formation of seroma – accumulation of lymphatic fluid at the site of removal of the node.

If there are no complications, the patient can be discharged the next day or one day after the operation.

The attending physician and the patient receive the conclusion of the pathological examination of the sentinel lymph node 10-14 days after the operation. The presence or absence of melanoma metastases in the sentinel lymph node, according to a pathomorphological study, determines the stage of skin melanoma and the tactics of further patient management.

Directly during the operation, a histological examination of the lymph nodes is not carried out for two reasons:

1. Micrometastases, literally individual tumor cells, must be found under a microscope. To solve such a problem, an urgent study on cryosections (sections of frozen tissue) is not suitable. It is necessary to make many cuts, to examine the entire volume of the removed suspicious lymph node after technologically lengthy preparation of tissues, processing them with special dyes.

2. Clinical studies have shown that extended surgery when micrometastases are found in sentinel lymph nodes is not beneficial.

Thus, the goal of SLNB is to identify patients with stage III skin melanoma for prescribing preventive treatment.

If a metastasis is found in the sentinel lymph node, the patient is diagnosed with stage III skin melanoma and given systemic immuno- or targeted therapy.

If there is no sentinel lymph node metastasis, the diagnosis is stage I or II skin melanoma. Such a patient remains under dynamic observation.

According to world standards, patients with stage IIB and IIC skin melanoma, in addition to dynamic monitoring, can be prescribed systemic therapy with pembrolizumab (immunotherapy). However, in the Russian Federation, patients with thick ulcerative melanoma without metastases in the sentinel lymph nodes (stage IIB, IIC) are still prescribed systemic interferon therapy, despite the dubiousness of its effectiveness. The volume of dynamic observation and the list, as well as the frequency of diagnostic studies, depend on the stage of skin melanoma.

In Moscow and St. Petersburg, SLNB is performed, for example, in the following centers:

1. N.N. N.N. Petrova, Department of Bone, Soft Tissue and Skin Tumors

2. St. Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (Oncology)

3. FSBI N.N. N.N. Blokhin” of the Ministry of Health of Russia

To get to one of these centers for a consultation and such a diagnostic procedure, you must ask the district oncologist to send a telemedicine request. After the doctors of the center determine the indications for SLNB in ​​this patient, the district oncologist will receive a response and an invitation for hospitalization with an indication of the date.

The patient can also make an appointment with the doctors of these centers. For example, in order to perform BSLU at the National Medical Research Center of Oncology. N.N. Petrova, it is enough to make an appointment with any of the doctors of the Department of Bone, Soft Tissue and Skin Tumors.