Swelling of the elbow joint: causes, symptoms, diagnosis and treatment in Moscow

The elbow joint has a complex structure; it is formed by three bones, between which there are three simple joints. Muscles are attached to a common capsule formed by bones and joints. Swelling of the elbow joint can occur during an inflammatory process or injury, which damages not only the muscles, but also the general capsule. Swelling may not cause discomfort, but in most cases it limits movement and is accompanied by other pronounced symptoms.

The multidisciplinary Yusupov Hospital, located in Moscow, is a modern medical facility that helps patients with various diseases and disorders. If swelling of the elbow joint and other signs of a pathological process appear, you should consult a specialist to find out the reasons. A rheumatologist at the Yusupov Hospital, when consulting a patient with this problem, recommends immediately undergoing an examination at a modern diagnostic center.

Swelling of the elbow joint: causes

Swelling of the elbow joint most often appears after mechanical damage or excessive stress. In addition, swelling of the elbow joint can occur with the following diseases:

arthritis or arthrosis;
bursitis;
tendinosis;
gout.

When the elbow joint is injured, tissue swelling develops quickly. With a hidden inflammatory process, swelling occurs painlessly and slowly. If this symptom appears, you should immediately consult a rheumatologist, since serious injuries can cause a secondary infection and intense pain. With the development of edema due to inflammatory diseases, the hand may become deformed, which causes limited mobility.

Experienced rheumatologists, surgeons, rehabilitation specialists and exercise therapy instructors are ready to provide patients with this complaint with medical services that meet international standards. Studying the experience of foreign colleagues and using high-precision equipment and effective drugs can improve the quality of life of patients with severe forms of disease.

How to avoid getting skin cancer? What to avoid?

Sunlight. The most proven cause of both types of skin cancer, as well as melanoma, is exposure to sunlight. If you like to travel to hot countries, have fair hair and skin, or your work involves prolonged exposure to the sun, you should seriously consider UV protection.

Precancerous skin diseases are the next factor that may precede the development of the squamous cell form: actinic (solar) keratoses and cheilitis, leukoplakia, human papillomavirus infection of the mucous membranes and genitals. This type of tumor can also develop against the background of scar changes after burns or radiation therapy.

Contact with carcinogens

Various chemicals can lead to the development of skin cancer: arsenic and petroleum products.

Weakened immune system. People taking immunosuppressive drugs after an organ transplant or people living with HIV have an increased risk of developing squamous cell skin cancer.

Symptoms of elbow swelling

Swelling of the elbow joint, the causes of which are associated with mechanical damage or an infectious process, most often appears in children who move actively. Adults most often injure the joint during sudden movements or excessive physical exertion. This symptom, regardless of the reasons for its appearance, may be accompanied by:

pain when moving your hand, which does not allow you to perform even basic actions;
blue discoloration of the skin;
increased temperature in the affected area;
inability to perform flexion and extension movements.

With severe bruises and inflammation, discomfort can bother a person for a long period. If edema and accompanying symptoms are not treated, cartilage tissue damage and complications may develop. To prevent complications and professional treatment of edema and associated pathologies, you must consult a neurologist.

Specialists at the Yusupov Hospital provide patients with first aid for elbow injuries accompanied by severe pain and increased swelling, as well as for infectious diseases. Rheumatologists determine treatment tactics based on the patient’s condition, the causes of pathological symptoms and the extent of tissue damage. Patients at the Yusupov Hospital study the treatment plan and the cost of services before starting treatment.

Squamous cell carcinoma

It is less common than basal cell carcinoma, the second most common type of skin cancer, and has a slightly less favorable prognosis. However, it should be noted that the course of the disease much less malignant than that of melanoma.

Metastases occur relatively rarely - on average in 16% of cases [1]. In patients with squamous cell skin cancer less than 2 cm in size, the 5-year survival rate is about 90%; for larger sizes and tumor invasion into the underlying tissue, it is less than 50% [1].

It can occur on any part of the body, including the genitals and mucous membranes, but most often in places exposed to sunlight.

Symptoms and signs

What squamous cell skin cancer looks like depends largely on the clinical form of the disease.

The keratinizing form is a raised or flat surface covered with horny scales that can grow and fall off. If damaged, it may bleed.

Keratinizing form of squamous cell skin cancer

Photos in the initial stage

The initial stage of squamous cell carcinoma refers to a condition when the malignant process is limited to the epidermis - the outermost layer of the skin. It is referred to in the diagnosis as in situ or intraepidermal squamous cell carcinoma. This disease is not life-threatening if completely removed.

There are 2 forms of this phase of the disease:

Bowen's disease

Most often it is represented by single flat plaques, with clear boundaries, an asymmetrical shape, and uneven edges. The size reaches 7–8 mm. The formation may gradually increase, and peeling or crusting is often observed on the surface.

The color is red or brown, located on any part of the body. [3]

On my own behalf, I will add that in my practice, histologically confirmed Bowen’s disease occurred only once. It looked like a small (3 x 4 x 3 mm) flesh-colored lump with a smooth surface on the skin of the shaft of the penis in a 43-year-old man.

Bowen's disease

Erythroplasia Keira

The second form of early-stage skin cancer, which develops most often on the skin of the foreskin of the penis or the glans. Much less commonly, the disease affects the female external genitalia.

The most common appearance of Queyre's erythroplasia is a bright red spot with clear boundaries and a moist, shiny surface [3].

Erythroplasia Keira

Treatment of squamous cell skin cancer (NCCN, 2018)

As in the case of basal cell carcinoma, squamous cell carcinoma is divided into groups of high and low risks of recurrence and metastasis.

Area H: Facial mask (including eyelids, eyebrows, skin around eyes, nose, lips [skin and red border of lips], chin, lower jaw, skin/grooves in front and behind the auricle, temples, ears), genitals, palms and feet .

Area M: cheeks, forehead, scalp, neck and legs

Region L: trunk and limbs (excluding shins, palms, feet, nails and ankles)

Notes

The rim of hyperemia should be taken into account when measuring size.
Excisional biopsy is preferred over incisional biopsy.
The modified Breslow thickness measurement should exclude parakeratosis and crusting and should be taken from the base of the ulcer, if present.
Localization, regardless of size, may be a sign of high risk.
Area H implies high risk regardless of size.

The basic principles and methods of treatment for squamous cell carcinoma are the same as for basal cell carcinoma.

The main goal is to maintain functionality and cosmetic qualities. method is considered to be removal of the tumor, including 4–6 mm of healthy tissue with a low risk of recurrence and metastasis. For high-risk tumors, Mohs micrographic surgery or wider excision is recommended than for low-risk tumors.

Radiation therapy is useful in cases where other methods cannot be used. Platinum drugs (cisplatin, carboplatin) as well as EGFR inhibitors (cetuximab) can be used in chemotherapy for squamous cell carcinoma.

Diagnosis of elbow joint edema in Moscow

The appearance of severe pain may not always occur with swelling of the elbow joint, so some patients postpone visiting a medical facility and use traditional methods of therapy and self-medication. The incorrect combination and use of therapy methods can lead to serious consequences; in addition, it is impossible to carry out diagnostics at home and make a diagnosis without special knowledge.

When a disorder is identified and a diagnosis is made, a set of diagnostic measures is carried out at the Yusupov Hospital:

blood chemistry;
Magnetic resonance imaging;
radiography;
puncture of the synovial sac.

If a patient develops swelling of the elbow joint, the causes and treatment are interrelated, so without highly accurate test results it is impossible to carry out effective treatment. The diagnostic center of the Yusupov Hospital is equipped with European equipment, which allows not only to quickly process research results, but also to determine even minimal disorders in tissues.

Pulmonary lymphoma - what is it?

The lymphatic system of the lungs resembles a branched tree - its vessels penetrate the entire length of the chest and are responsible for lymph flow. There are 13 types of lymph nodes, classified into 5 groups:

1.Supraclavicular lymph nodes;

2.Upper medial lymph nodes (paratracheal, prevascular, prevertebral);

3.Aortic lymph nodes;

4.Lower mediastinal lymph nodes;

5.Root, lobar, (sub)segmental lymph nodes.

In the nodes, lymph is filtered and lymphocytes mature. Lymphomas arise in the lymph nodes.

Affected lymph nodes are often not visible or palpable. Pathological changes - enlarged lymph nodes, tissue compaction - are clearly visible on a high-resolution multi-slice CT scan or MRI. To determine the specifics of the neoplasm (normal or malignant process), the attending physician may refer the patient for histological examination. In some situations, an increase in nodes is a relative norm (after infectious and inflammatory diseases, injuries, allergic reactions), in others it indicates an oncological process. In the latter case, we can talk about lymphoma.

Since the lymphatic system is a vast network of vessels, capillaries and cavities, malignant cells can spread throughout the body, forming multiple disseminated metastases.

Treatment methods for elbow joint swelling

For swelling of the elbow joint, medical and surgical treatment methods are effective, which can be supplemented by other procedures. If swelling of the elbow joint develops rapidly after an injury, the patient is given first aid and cold is applied to the area.

Drug treatment of inflammatory processes is based on the use of non-steroidal anti-inflammatory drugs in the form of tablets and ointments. In addition, the patient may be prescribed various groups of antibiotics. In addition to the main therapy during the period of remission, massages, physiotherapeutic procedures and physical therapy are provided.

Swelling of the elbow joint due to purulent inflammation requires surgical intervention. Specialists at the Yusupov Hospital prefer minimally invasive surgical treatment methods, since after using them the patient can return to an active life in the shortest possible time.

Basal cell skin cancer

Basalioma is the most common, but at the same time the safest type of skin cancer. Death from basal cell carcinoma is possible only in very advanced cases or with aggressive forms (basosquamous) tumor. The favorable course of basal cell carcinoma is due to the fact that it almost never metastasizes (only 0.5% of cases).

Symptoms and signs

Most often, basal cell carcinoma occurs on the skin of the nose, a little less often on the face and much less often on other parts of the body.

The peak incidence occurs over the age of 40 years. The youngest patient diagnosed with basal cell carcinoma by histology was 39 years old.

What basal cell skin cancer looks like depends on the form:

Nodular form (synonymous with nodular). The tumor is presented in the form of a nodule. It can be distinguished from other skin formations by an increased number of vessels on the surface, a waxy sheen and small gray-blue inclusions. All these signs are visible in the photo.

Nodular form of basalioma
In addition, on the surface of nodular basalioma there may be another characteristic sign - ulceration.

Nodular basal cell carcinoma with ulceration

The superficial form of basal cell carcinoma in most cases is presented as an area of redness on the skin. Elements of peeling and the waxy sheen already mentioned above are also possible.

Superficial form of basalioma

Scleroderma-like form of basalioma is very rare and often presents difficulties in diagnosis. It is characterized by a lighter and harder seal compared to the surrounding skin.

Scleroderma-like form of basalioma

The pigmented form of basal cell carcinoma makes up a very small part of the total number of these tumors. It is distinguished by a large amount of pigment. In this regard, basal cell carcinoma is often mistaken for melanoma when examined without a dermatoscope.

Pigmented form of basalioma

The ulcerative form of basalioma can reach very large sizes and in advanced cases is practically untreatable.

Ulcerative form of basalioma

Photos in the initial stage

Unfortunately, basal cell skin cancer is extremely difficult to diagnose in the early stages, i.e. when it is minimal in size. Here are some photos:

Basalioma of the skin of the nose, nodular form, size 5 mm

Basalioma, nodular form, 3 mm in diameter

Nodular basalioma of the temporal region, diameter 2 mm

Diagnosing basal cell carcinoma in the early stages, when the tumor is small, can present significant difficulties. Only a combination of a comprehensive examination of the entire skin, a thorough determination of the history of the existence of the formation and dermatoscopy will help in establishing the diagnosis of basal cell carcinoma at an early stage.

Basaliomas with high and low risk of recurrence (NCCN, 2018)

Area M: cheeks, forehead, scalp, neck and legs

Region L: trunk and limbs (excluding shins, palms, feet, nails and ankles)

Notes

Localization, regardless of size, may be a sign of high risk
Histological forms of low risk: nodular (nodular), superficial, keratotic, piloid, with differentiation towards skin appendages, Pincus fibroepithelioma
Area H means high risk regardless of size
Morphea-like, basosquamous (metatypical), sclerosing, mixed infiltrative, micronodular in any part of the tumor

To assign a tumor the status of “high risk of recurrence”, only one of the factors from the right or left column is sufficient.

Treatment of basal cell carcinoma

The main goal of treatment for basal cell carcinoma is complete removal of the tumor while maximally preserving the cosmetic properties and functions of those parts of the body where this tumor has developed.

As a rule, the best results are achieved by surgical methods. However, the desire to maintain functionality and cosmetic properties may lead to the choice of radiation therapy as the primary treatment modality.

Depending on the degree of risk of relapse (see above), the approach to treating basal cell carcinoma may vary.

In patients with superficial basal cell carcinoma and a low risk of recurrence, when surgery or radiation therapy is contraindicated or inappropriate, the following treatments may be used:

5-fluorouracil ointment;
Imiquimod ointment (Aldara, Keravort);
photodynamic therapy;
cryodestruction.

Mohs micrographic surgery may be recommended for patients at high risk of recurrence.

Chemotherapy for basal cell carcinoma includes drugs that are inhibitors of the hedgehog signaling pathway – vismodegib (Erivedge) and sonidegib (Odomzo). These drugs can help in cases where surgical methods, like radiation therapy, are not applicable or contraindicated.

What you need to know about basal cell carcinoma?

In the vast majority of cases, basal cell carcinoma does not pose a threat to life.
If a histological examination of a distant formation results in basal cell carcinoma, there is nothing to worry about. It is important to make sure that the formation is completely - be sure to consult with an oncologist.
If, after removal of a basal cell carcinoma, the histological examination contains the phrase “tumor cells in the resection margin” or something similar, further treatment in order to completely remove the tumor.
strongly do not recommend removing basal cell carcinoma without histological examination, since even a very typical-looking formation may not be what it seems at first glance.
Basalioma needs to be treated . Observation is a bad option for a diagnosis like this. Treatment of advanced forms (see photo of ulcerative form) is extremely difficult and expensive.
If you have already had a basal cell carcinoma removed, you should regularly have your entire skin examined by an oncologist in order to possibly identify another such tumor.
The likelihood of metastasis in the metatypical (basosquamous) histological type is higher than in other types.

Treatment of swelling of the elbow joint at the Yusupov Hospital

Treatment of swelling of the elbow joint and associated pathologies in the therapy clinic of the Yusupov Hospital is carried out according to individual programs developed by a team of experienced specialists. When interacting with patients, rheumatologists find out why swelling of the elbow joint appeared, the causes of associated pathologies and the nature of tissue damage.

Interdisciplinary cooperation implemented in a medical institution allows us to build the most effective treatment tactics for patients and use innovative methods. If necessary, the initial treatment plan can be supplemented and adjusted.

An important advantage of treatment at the Yusupov Hospital is the comfortable living conditions for patients, who receive not only a full range of medical services, but also information support. During inpatient treatment, patients are accommodated in comfortable rooms that have the necessary equipment, furnishings and hygiene products.

The pre-appointment system allows not only to optimize the work of a medical institution, but also to effectively plan patients’ own time. To make an appointment for a consultation or examination, contact the Yusupov Hospital staff by phone.

Types of skin cancer

There are 3 types of common malignant skin tumors. They differ both in incidence (i.e., the chance of getting sick) and in the degree of danger to life - basal cell carcinoma, squamous cell carcinoma and melanoma.

Melanoma is one of the rare and dangerous skin tumors. It accounts for only 4% of the total number of malignant skin tumors, but is the cause of almost 80% of deaths in this localization. You can read more about melanoma here.

Diagnosis of pulmonary lymphoma

Typically, medical specialists prefer MRI, since there is no radiation exposure; however, in the case of examining the air tissue of the lung parenchyma, which normally contains virtually no fluid, the most detailed examination results and detailed images can be obtained using a CT scan of the lungs. If lymphoma is detected on an MRI and the doctor suspects that cancer cells have migrated into the bone tissue, the patient will be advised to further examine the bones. During computed tomography, tissues of different morphologies that fall within the area of interest are examined: bones, internal organs, blood vessels. To diagnose the latter, additional contrast is required.

Read the article “CT with contrast”

What types of lymphomas are there?

Primary lymphomas are usually divided into two large groups:

Hodgkin's lymphomas/lymphogranulomatosis (Hodgkin's disease, Hodgkin's lymphomas),
Non-Hodgkin's lymphomas (lymphosarcoma, NHL).

According to the National Medical Research Center of Oncology named after. N.N. Blokhin, in Russia the incidence of non-Hodgkin's lymphomas is 1.5-3 times higher than the incidence of lymphogranulomatosis.

The difference between these lymphomas becomes clear after morphological examination of a tissue sample (biopsy). In Hodgkin's disease, large mutated Berezovsky-Sternberg-Reed cells are found in the affected lymph nodes. Hodgkin's lymphomas have a more aggressive course with pronounced symptoms, but they are easily treatable.

Lymph nodes affected by Hodgkin's disease are most often located above the collarbones, in the neck, armpits, and mediastinum.

In addition to B-lymphocytes, non-Hodgkin's lymphomas also affect T-lymphocytes. The disease usually occurs without significant symptoms and is difficult to treat. But first you need to correctly determine the type of non-Hodgkin lymphoma - the current classification consists of 30 names, including:

chronic lymphocytic leukemia;
T-cell leukemia;
follicular lymphoma;
diffuse large B-cell lymphoma;
mycosis fungoides Sézari et al.