Doctor Zhao, help!

Chapter 174 Extremely rare subungual glomus tumor

"Old man, please stretch your hand over and let me take a closer look."

Zhao Sheng said to the old lady.

"Don't worry, I won't touch it."

After a pause, Zhao Sheng looked at the frightened old lady and said.

"Doctor, as promised, you won't touch it!"

The old lady closed her eyes tremblingly, gritted her teeth, and stretched out her left hand in front of Zhao Sheng.

Only then did Zhao Sheng carefully observe the old lady's left thumb. Well, the thumb looked rosy in color as a whole, and the color of the nail bed was normal, with no gray parts.

Taking a closer look, Zhao Sheng discovered something was wrong. There was a dark red mass the size of a soybean at the base of the thumb of the old lady's left hand.

This small lump is dark red, which is very similar to the color of the nail bed. You can't spot it at all if you don't look carefully.

Is the problem here?
Zhao Sheng couldn't help but think.

Because the difference between the color of this small lump and the color of the nail bed is very small, that is, with Zhao Sheng's current super powers of observation, he could see it all at once.

It seemed that no one had noticed this small mass under the nail despite the old lady's visits so many times before.

Thinking of this, Zhao Sheng casually picked up a cotton swab from the table.

"Old man, I'll check you out later, please bear with me."

Zhao Sheng said to the old lady.

"Mom, just be patient. What if you are found out this time?"

The old lady's son also told the old lady.

"Doctor, come on!"

At this time, the old lady mustered up her courage, stretched out her left hand, and said to Zhao Sheng as if she was going to die heroically.

In the past two years, she has been tortured to the point of becoming mentally ill.

"Okay, bear with it."

Zhao Sheng picked up the cotton swab, used the base of the cotton swab to gently press on the dark red mass on the nail bed.

"Ouch...doctor...it hurts!"

The base of the cotton swab only slightly touched the small dark red mass under the nail bed, and the old lady screamed.

Pin press test positive!
Seeing the old lady's violent reaction, Zhao Sheng was immediately convinced.

This pin press test is a specific test for subungual glomus tumor.

This positive test, coupled with the small dark red mass seen under the nail bed, can basically be diagnosed as subungual glomus tumor.

So what is a subungual glomus tumor?

Subungual glomus tumor is a rare benign small hemangioma that rarely undergoes malignant transformation. It is located under the reticular layer of the dermis and originates from normal arterioles and venous shunts. It has an organ-like structure and is composed of glomus tumor cells. , about 1mm in diameter, surrounded by unsheathed nerve fibers.

It usually occurs on the fingers, toes, and under the nail bed, and is mostly single hair. It is more common in young and middle-aged people, and is slightly more common in women than men.

The most distinctive feature of this disease is localized severe pain with significant tenderness and spontaneous pain. This pain is very severe, like acupuncture and burning.

Seeing the change in Zhao Sheng's expression, the old lady's son couldn't help but ask with a glimmer of hope: "Doctor, what is going on with my mother's illness?"

"The initial suspicion is that it is a subungual glomus tumor, but an MRI of the finger is still needed to confirm the diagnosis."

Zhao Sheng said.

In fact, from the perspective of palpation and visual inspection, the diagnosis of the old lady's subungual glomus tumor was very clear. The reason why another finger MRI examination was needed was to have imaging examinations to support the diagnosis.

After all, this old lady's subungual glomus tumor requires surgery. If surgery is required, imaging examinations must be performed to support the diagnosis.

"Subungual glomus tumor? What disease is this? Isn't it paronychia?" the old lady's son asked with a puzzled look.

This was the first time he had heard of this disease.

Even the old lady looked at Zhao Sheng with some excitement at this time. She had seen the disease so many times. This was the first time that a doctor could tell with such certainty what the disease was that caused her finger pain.

"To put it simply, it means that there is a small hemangioma in the nail bed, that is, under the nail root. Once the small hemangioma is pressed or stimulated, severe pain will occur."

"Pulling the nail will only temporarily relieve the pressure of the nail on the small hemangioma under the nail bed, so the pain can only be relieved for a short period of time at a time."

Zhao Sheng patiently explained to the mother and son.

"Doctor, can my mother's disease be cured?"

When the old lady's son heard what Zhao Sheng said, he felt mixed joy and sorrow. On the one hand, he was finally able to determine what the disease was. On the other hand, he felt that after seeing the disease so many times without a diagnosis, what if it was a terminal illness?

"Doctor, I heard you clearly. I have a tumor on my finger. It needs to be chopped off, no, it needs to be amputated, right?"

"Doctor, come on, I'm here today to do this!"

The old lady seemed to understand Zhao Sheng's explanation and said very confidently.

"Old man, the cause of the severe pain in your finger is the subungual hemangioma. So as long as this small hemangioma is removed, you will be fine. There is no need to amputate the finger."

Hearing what the old lady said and seeing her determined look ready to chop off her hands, Zhao Sheng couldn't help but explain in a dumbfounded way.

Why is this old lady always thinking about chopping off her hands?

"Is there really no need for amputation?"

The old lady still said in disbelief.

"It's really not necessary. Let's get checked first. Once we get the test results and confirm the diagnosis, we'll prepare for hospitalization for surgery."

Zhao Sheng said slowly.

"Ah? Doctor, can you really see my illness? Just by looking at it?"

The old lady still said in disbelief.

I had seen her so many times before, but I still couldn't completely determine what was going on with her. How did you get to Zhao Sheng's place, and just by looking at it and poking it with a cotton swab, you could determine what kind of disease she had?
"Subungual glomus tumor is a rare disease. If you don't happen to know about this disease, it would be difficult to think about it."

Zhao Sheng explained.

This is the role of knowledge, experience, and clinical thinking.

Clinically, sometimes there are blind spots in knowledge and thinking. Just like this subungual glomus tumor, the cause is actually not complicated. It is just a hemangioma growing on the nail bed, causing severe pain.

But if you have never been exposed to or even heard of this rare disease, you would never think of it.

Thinking is very important, just like before the invention of horseshoes, the fate of a horse depended on the degree of wear and tear of the horseshoes, because no one had ever thought of putting boots on the horseshoes.

Clinically, this is particularly evident.

Many times, patients do not receive effective treatment, either because it is impossible or unexpected.

"Mom, the doctor is a doctor, so just believe what the doctor says."

The old lady's son is quite knowledgeable, and he can understand what Zhao Sheng said.

"Ah Hui, Mom listens to you."

The son said so, and the old lady nodded.

However, she was still a little doubtful, because Zhao Sheng looked very young. If Zhao Sheng had the same image as before, he would definitely be able to make the old lady trust him immediately.

But Zhao Sheng's hair has grown back, and his overall temperament and image have been improved like a plastic surgery. This is completely different from the old lady's impression of the gray-haired old professor.

(End of this chapter)