Clinical Examination of a Swelling

History ( Elicit under 15 headings )

1.Mode of Onset

2.Duration

3.Pain

4.Fever

5.Associated Symptoms

 6.Site of Origin

7.Progress

8.Secondary Changes

9.Any other Swelling

10.Impairment of Function

 11.Loss of weight

12.Recurrence

13.Past history

14.Personal History

15.Family History

Inspection ( Describe under 15 headings )

1.Number

2.Site

3.Size

4.Shape

5.Surface

  

6.Skin

7.Extent

8.Edge/Margin

9.Impulse on Coughing

10.Pressure Effects

 11.Pulsation

12.Peristalsis

13.Movement with Respiration

14.Movement with Deglutition

15.Movement with Protrusion of Tongue

Palpation ( Describe in 15 headings)

1.Local Rise of Temperature & Tenderness

2.Number-Single/Multiple

3.Site

4.Shape

5.Surface

 6. Consistency

7. Margin/Edge

8. Extent

9. Fluctuation

10. Transilluminancy

 11. Pulsation

12. Thrill

13.  Reducibility

14.  Compressibility

15.  Plane of the Swelling-Skin/Subcutaneous/Deep to Muscle or Fascia/Bone

Difference between Reducibility and Compressibility

Reducibility - By the application of External pressure the swelling reduces in size. The swelling reappears only when the intra abdominal pressure is increased by the act of coughing/Valsalva's manoeuvre.

Reducibility is a feature of Hernia

Compressibility-By the application of External pressure the swelling reduces in size. The swelling reappears as soon as the pressure is released.

Compressibility is a feature of Haemangioma/Lymphagioma