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This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.
In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.
***Thanks to the patient for sharing his history and exam with YouTube world***
Function and Anatomy: The hip is a ball and socket type joint, formed by the articulation of the head of the femur with the pelvis. Normal range of motion includes: abduction 45 degrees, adduction 20-30 degrees, flexion 135 degrees, extension 30 degrees, internal and external rotation. Hip pathology can cause symptoms anywhere around the joint, though frequently pain is anterior and radiates to the groin region. Additionally, pathology outside of the hip can be referred to this region. History and exam obviously help in making these distinctions.
Lipomas are single or multiple, benign subcutaneous tumors that are easily recognized because they are soft, rounded, or lobulated and movable against the overlying skin. Many lipomas are small but may also enlarge to 6 cm. They occur especially on the neck, trunk, and on the extremities but can occur anywhere on the body. Lipomas are composed of fat cells that have the same morphology as normal fat cells, and there is a connective tissue framework. Angiolipomas have a vascular component and may be tender in cold ambient temperature. These often require excision, whereas other lipomas should be excised only when considered disfiguring. Liposuction can also be performed when liposomas are soft and thus have only a minor connective tissue component.