Doctors Lounge - Orthopedics Answers
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Forum Name: Bone trauma and fractures
|aerodave88 - Thu Nov 19, 2009 3:59 pm|
I broke my 5th Metacarpal bone about 7 weeks ago, just came out of cast last wednesday. The Xray showed the fracture is not properly healed, it was in a cast for 2 weeks, then 3 weeks..I had it for a week without knowing...
Anyway, ive noticed swelling in my armpit, doctor said its lymph node and that its most probably due to the broken bone in my hand.. The swelling is on the right armpit, and the fracture is in my right hand.
I noticed small swelling and tenderness about 2 weeks ago in my armpit, but since yesterday its gotten larger and more tender and red on the skin. Is this normal? I also think i am fighting a small chest infection. The size of the node feels small enough, about 1-2cm at the most, and its quite rubbery/tender...Its not painful, more uncomfortable.
Thank you, any advice much appreciated.
|Dr.M.Aroon kamath - Fri Feb 19, 2010 12:29 am|
The broken metacarpal by itself would not be normally expected to cause enlargement of the axillary lymph node.However, skin lesions (excoriations,furuncles etc) may occur under the casts which can certainly cause this.Any other septic lesion in the area of drainage of the axillay lymph nodes must also be excluded.
If these are excluded, then, most clinicians would perhaps start a course of antibiotics and observe the response.If the 'acute lymphadenitis' does not respond in a week or two, further investigations(such as Fine needle aspiration-FNA or an open biopsy) may be needed.
|Dr. A. Saif - Thu Feb 25, 2010 6:03 pm|
Absolutely agree with Dr Kamath. If the fracture of the 5th metacarpal occurred with minimal trauma (you suggest that you had had it for a week without knowing about it) then it is imperative that you exclude conditions that can lead to spontaneous fractures. Normally fractures of the 5th Metacarpal do heal readily...although they may heal with some deformity, so I am not clearly what you mean by "not healed properly"...
If there has been no signs of progress towards healing, and certainly if there was no history of trauma to cause the fracture I would agree that a biopsy is more important than antibiotics. If the lymph node is not painful (most infected lymph nodes are) then again biopsy should be high on the list of priorities.
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