Kinds
Osteogenic sarcoma of the leg
This type of leg cancer is a nonepithelial bone tumor.
The location of the leg sarcoma is very important:
- On the back of the lower leg;
- On the front of the shin.
Symptoms and development
If it is diagnosed on the back of the lower leg, it may not be noticeable for quite a long period, since it is hidden by the gastrocnemius major muscle.
If the cancer is on the front of the leg, then it is quite easy to diagnose its development and enlargement, due to changes in the condition of the skin above the tumor. It stretches and changes color.
Further from the lower leg, the sarcoma can spread to the fibula and tibia. This cancer can destroy the membranous connections between bones, causing frequent fractures.
In the first stages, pain does not occur with this disease. Only when the tumor grows does it put pressure on nearby nerves and vessels, causing pain. The pain spreads to the foot and toes, swelling appears, and trophic skin disorders may occur.
Soft tissue sarcoma of the leg
There are two types of soft tissue sarcoma of the leg:
- Superficial;
- Deep.
Symptoms and development
The first type of soft tissue cancer of the leg can be diagnosed in the early stages. The second one can be almost asymptomatic. There may be complaints of pain in the lower leg of a bursting and pulling nature.
As the disease progresses, its symptoms also intensify. Here are the main ones:
- Weakness without a specific reason;
- Anemia;
- Severe weight loss;
- Nausea;
- Lack of appetite;
- Fever.
Further, as it grows, the sarcoma presses on the vessels and nerves located in the foot area. Because of this, swelling of the feet and trophic ulcers appear, sensitivity in the toes worsens, and they begin to move worse.
Osteosarcoma
Lower leg area Anterior lower leg area
Nye of the entire joint (drives).
Borders of the area: at the top – a circular line passing through the tibial tuberosity; below – a circular line drawn through the bases of the ankles; medially – the inner edge of the tibia; laterally – the groove between the peroneal muscles and the soleus muscle.
Leather
thin, has hair.
The subcutaneous tissue
is poorly developed.
The superficial fascia
is well expressed, forms fascial sheaths for the great saphenous vein,
branches n. saphenus.
Own fascia
(fascia cruris) is well expressed and
develops two intermuscular septa (anterior and posterior), due to which in the anterior region of the leg there are two osteo-fibrous beds: anterior and lateral. The anterior intermuscular septum is located between the extensors and peroneal muscles and forms the lateral side of the anterior
of the osteo-fibrous bed. The medial side of the bed is formed by the outer surface of the tibia, and the posterior
- interosseous membrane.
In the front box there are m. tibialis anterior, and lateral to it – m. extensor digitorum longus. In the depths between
The extensor pollicis longus passes through it. Between the muscles on the interosseous membrane passes a. tibialis anterior
with two accompanying veins and n.
peroneus profundus. In
the upper third of the leg, the nerve is located lateral to the artery, in the middle third it crosses the artery in front, in the lower third it passes medially from the artery.
In the lateral part of the tibia there is a closed fibrous bed, limited by the intermuscular septa and the outer surface of the fibula. It contains mm. peroneus longus et brevis and superficial peroneal nerve. In the upper third of the leg, the nerve pierces the anterior intermuscular septum and for some distance passes between the fibula and the long peroneus muscle in the canalis musculoperoneus superior . At the border of the lower and middle thirds of the leg, the superficial peroneal nerve pierces the fascia and enters the subcutaneous tissue.
Posterior region of the lower leg Borders (see anterior area of the lower leg). Leather
thin,
movable. Subcutaneous tissue
it is expressed moderately, the branches of the lateral and medial cutaneous nerves of the calf pass through it. Posterior to the medial edge of the tibia are the great saphenous vein and n. saphenus.
Superficial fascia
has one leaf. V. saphena par-va and n. cutaneus surae medialis only in the middle third of the leg are located in the fascial sheath of the superficial fascia, and
in the upper third – in the splitting of the own fascia (Pirogov’s canal).
Own fascia
participates in the formation of the posterior fascial bed, limited:
in front
- by the tibia and interosseous membrane;
laterally
– the posterior intermuscular septum and fibula;
medially
– by the fascia proper and the tibia;
behind
– by the own fascia of the leg.
The posterior bed is divided by a deep layer of crural fascia
into 2 sections: superficial and deep. Superficial section
contains the gastrocnemius, soleus and plantar muscles
tsy. In the deep part
are located m. flexor digitorum longus, m. flexor hallucis longus, m. tibialis posterior.
Neurovascular bundle of the posterior region of the leg
(posterior tibial vessels and tibial nerve) passes between the deep and superficial layers of the leg muscles in
the canalis cruropopliteus . The canal is limited: in front
- m. tibialis posterior;
behind
– deep layer of fascia of the leg, covering m.
so-leus; on the medial side
– m.
flexor digitorum longus; on the lateral side
– m. flexor hallucis longus. The canal has an upper
It has an inlet, two side branches (holes) and a lower outlet.
Inlet
is a gap between arcustendineus m.
solei and m. popliteus. The popliteal
pass through this gap .
Immediately after entering the canal, the popliteal artery divides into the anterior and posterior tibial arteries.
First branch
It is a hole in the interosseous membrane through which the anterior tibial artery emerges into the anterior bed of the leg.
Second branch
– this is the origin of the peroneal artery in the middle third of the leg, which passes into the gap between m.
flexor hallucis longus and fibula ( canalis musculoperoneus inferior ).
Bottom outlet
– this is the gap between the surface-
thick and deep layers of muscles of the posterior region of the leg in the lower third, through which the neurovascular bundle penetrates into
ankle tunnel
.
Phlegmon of the posterior region of the leg can be:
— superficial – subcutaneous and subfascial;
- deep - localized in the intermuscular spaces of the lower leg and canalis cruropopliteus. Phlegmons of the deep fascial bed of the posterior region of the leg can spread along the vessels to neighboring areas (popliteal fossa, anterior area of the leg, foot).
Ankle joint area Boundaries : upper – circular line drawn above the base
twisting ankles; lower - two lines drawn between the tops of the ankles through the sole and back of the foot. From practical
For technical reasons, anterior, medial, lateral and posterior regions are distinguished.
In the anterior area the skin
thin, mobile.
Subcutaneous tissue
is poorly expressed, tributaries pass through it. saphenamagna, branches n. saphenus, n. peroneus superficialis.
Own fascia
compacted, looks like
extensor retinaculum
.
The cruciate ligament gives off spurs to the joint capsule, forming 3 fibrous canals in which the extensor tendons lie, surrounded by synovial sheaths.
The anterior tibial artery with the deep peroneal nerve passes through the middle canal to the dorsum of the foot. In the medial region, the own fascia forms
retinaculum of tendons - flexors, which throws -
lies between the medial malleolus and the calcaneus, forming the ankle tunnel
(
canalis malleolaris ).
The canal contains the flexor tendons of the fingers, as well as the posterior tibial artery with veins and the tibial nerve. The tendons are separated from each other by fibrous septa and surrounded by synovial sheaths. The neurovascular bundle has its own fascial sheath; at the exit from the canal it is divided into medial and lateral neurovascular bundles of the sole. In the lateral area of the ankle joint in the subcutaneous tissue
the sources are located.
saphena parvain.suralis. The fascia proper
forms
two retinaculum (superior
and inferior) of the peroneal muscles ,
limiting the lateral ankle canal. It contains the tendons of the peroneus longus and brevis muscles, surrounded by a common synovial sheath.
Skin in the posterior area
thick, folded.
In the subcutaneous tissue
there are arterial anastomoses between the calcaneal branches of the posterior tibial and peroneal arteries.
The proper fascia
forms a sheath for the calcaneal tendon, under which in the area of the calcaneal tubercle there is a synovial bursa.
Diagnostics
Osteogenic leg cancer is easily diagnosed on the front of the leg. If it is on the back, then it is much more difficult to diagnose because of the calf muscle, which hides the tumor.
Superficial cancer of the soft tissues of the leg is also much easier to diagnose than asymptomatic deep cancer of the soft tissues of the leg.
If cancer of the leg is suspected, laboratory tests are performed, a computed tomography scan is performed, an X-ray of the leg is taken, and magnetic resonance imaging is performed.
A biopsy is done to confirm leg cancer. Next, it is checked whether leg cancer has metastases in other organs.
Muscle tissue of the lower leg
The muscles form three groups. The anterior subgroup includes:
- Tibialis anterior muscle - is attached to the medial wedge-shaped and first metatarsal bones, runs along the entire length of the tibia. It can be easily felt under the dermis, especially in the transition area to the foot. The function is to extend and supinate the feet.
- Extensor digitorum longus – located on the outside of the tibialis anterior muscle, in the upper part of the lower leg. When moving to the foot, it is divided into 5 tendons, attached to the 2,3,4,5 toe, the last part is attached to the base of the fifth metatarsal bone. The function is to extend the foot and fingers.
- The extensor pollicis longus is weaker than the previous muscle formations between which it is located. Attached to the base of the distal phalanx, it is used for extension and supination of the feet and big toes.
The posterior subgroup is formed:
- The triceps surae muscle is located at the back and has three heads. Two of them are the gastrocnemius muscle, the last one is the soleus. Together they pass into the Achilles tendon, which attaches in the area of the tubercle on the heel bone. It is responsible for flexion at the knee joint of the leg and foot at the ankle.
- Flexor digitorum longus – responsible for supination and flexion of the foot and toes. It starts from the posterior part of the tibia, passes under the foot in the canal located under the retinaculum of the flexor tendons.
- Flexor pollicis longus is one of the strongest deep formations on the back of the lower leg. Used to flex the foot and big toe, partially for the 2nd and 3rd toes.
- Posterior tibialis muscle - located under the triceps muscle of the leg, in the lower area it is attached to the sphenoid bones and the bases of the metatarsal bones, the tuberosity of the scaphoid bone. Responsible for supination, adduction and flexion of the feet.
- The popliteus muscle is a flat and short muscle that is adjacent to the knee joint on the back side. Used for pronation and flexion of the lower leg.
The external third subgroup includes:
- The peroneus longus muscle has a feathery structure and is located on the outer portion of the bone of the same name. It starts from its head, the fascia of the leg and the lateral condyle of the tibia and the outer part of the fibula, in the region of its upper two-thirds. Attached to the lower surface of the first metatarsal, to the medial cuneiform and second metatarsal bones. Necessary for pronation, abduction and flexion of the feet.
- The peroneus brevis muscle originates from the outer portion of the peroneus brevis muscle and the intermuscular septa. It is attached to the tuberosity of the 5th metatarsal bone. Responsible for pronation, abduction and flexion of the foot.
Pain on the front of the thigh: causes
Pain in the upper front part of the legs is most often caused by pathologies of the soft tissues that surround the hip joint, or more precisely, rupture/stretching or inflammation of the iliopsoas muscle, tendons and ligaments. If your hips hurt, this could be due to:
- changes in joint tissues;
- diseases of internal organs (urolithiasis, angina pectoris, cholecystitis, etc.);
- vascular diseases (varicose veins);
- oncological processes (metastases);
- psychological factors, etc.
The hip hurts in the front and if osteochondrosis develops in the lumbosacral spine (the roots of the L3 and L4 vertebrae are affected), if the patient has Bernhard-Roth disease.