Pandey C R, Singh N, Tamang B
Department of Orthopaedics, Grande International Hospital Kathmandu, Nepal.
Malays Orthop J. 2017 Mar;11(1):47-51. doi: 10.5704/MOJ.1703.020.
Diagnosis of subungual glomus tumour is mostly based on detailed history and clinical examination. Recently, Magnetic Resonance Imaging (MRI) and Ultrasound have been proposed as the imaging modality to confirm the clinical diagnosis and in planning the surgical management of these tumours. However, these imaging modalities are not routinely available in rural setting and also are expensive. Due to these limitations, we set out to establish that diagnosis and management of these rare tumours can be based solely on a battery of clinical tests and history taking.
Retrospectively, we reviewed nine cases of glomus tumour. A clinical evaluation proforma was developed on the basis of clinical history and specific clinical test for diagnosis of these tumours. All the cases were evaluated and treated surgically by a single surgeon with a specific technique. Post-operatively, diagnosis was confirmed by histopathological examination.
Females (77.78%) were predominantly affected in this series and the tumours commonly occurred in the right hand (66.66%). Spontaneous pain, cold sensitivity test and Love's Pin test was positive in all cases (100%). Hildreth's test was positive in 88.89%. In none of the cases the tumours recurred during minimum follow-up of one year. In all cases, histopathological examination confirmed the preoperative diagnosis of glomus tumours.
Diagnosis of glomus tumours can be made clinically based on history taking and clinical examination. Magnetic Resonance Imaging and Ultrasound are not necessary for diagnosis and management of typical subungual tumours.
甲下血管球瘤的诊断主要基于详细的病史和临床检查。最近,磁共振成像(MRI)和超声已被提议作为成像方式,以确认临床诊断并规划这些肿瘤的手术治疗。然而,这些成像方式在农村地区并非常规可用,而且费用昂贵。由于这些限制,我们着手确定这些罕见肿瘤的诊断和治疗可以仅基于一系列临床检查和病史采集。
我们回顾性地分析了9例血管球瘤病例。基于临床病史和针对这些肿瘤诊断的特定临床检查制定了一份临床评估表格。所有病例均由一名外科医生采用特定技术进行评估和手术治疗。术后,通过组织病理学检查确认诊断。
在本系列中,女性(77.78%)受影响为主,肿瘤常见于右手(66.66%)。所有病例(100%)的自发疼痛、冷敏感试验和洛夫针试验均为阳性。希尔德雷思试验88.89%为阳性。在至少一年的最短随访期内,无一例肿瘤复发。所有病例的组织病理学检查均证实了术前血管球瘤的诊断。
血管球瘤的诊断可基于病史采集和临床检查在临床上做出。磁共振成像和超声对于典型甲下肿瘤的诊断和治疗并非必需。