What is the cause of a tender knot at the femoral incision site in the right groin area, measuring 0.76x2.12x0.74, following stent (percutaneous transluminal angioplasty) placement surgery on March 14, with persistent soreness since then?

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Differential Diagnosis for Tender Knot at Femoral Incision Site

  • Single Most Likely Diagnosis
    • Hematoma: Given the patient's recent surgery and the presence of a tender knot at the incision site, a hematoma is the most likely diagnosis. The ultrasound findings of a well-defined mass in the right groin area, measuring 0.76x2.12x0.74, support this diagnosis. Hematomas are common complications after surgical procedures, especially those involving vascular access.
  • Other Likely Diagnoses
    • Seroma: A seroma is a collection of fluid that can occur after surgery, and it's possible that the patient has developed a seroma at the incision site. The ultrasound findings could be consistent with a seroma, although the presence of a tender knot might suggest a hematoma.
    • Abscess: An abscess is a collection of pus that can occur after surgery, and it's possible that the patient has developed an abscess at the incision site. The presence of a tender knot and the patient's report of soreness since the surgery support this diagnosis.
    • Pseudoaneurysm: A pseudoaneurysm is a complication that can occur after vascular surgery, where a false aneurysm forms at the site of the vascular access. Although the ultrasound findings do not suggest a connection to the common femoral vein (CFV) or great saphenous vein (GSV), a pseudoaneurysm is still a possible diagnosis.
  • Do Not Miss Diagnoses
    • Deep Vein Thrombosis (DVT): Although the ultrasound findings do not suggest a DVT, it's essential to consider this diagnosis, especially given the patient's recent surgery and immobility. A DVT can be life-threatening if not diagnosed and treated promptly.
    • Arteriovenous Fistula (AVF): An AVF is a complication that can occur after vascular surgery, where an abnormal connection forms between an artery and a vein. Although the ultrasound findings do not suggest an AVF, it's crucial to consider this diagnosis, as it can lead to significant morbidity if not diagnosed and treated.
  • Rare Diagnoses
    • Soft tissue tumor: Although rare, it's possible that the patient has developed a soft tissue tumor at the incision site. The ultrasound findings could be consistent with a tumor, although this diagnosis is less likely given the patient's recent surgery and the presence of a tender knot.
    • Vascular malformation: A vascular malformation is a rare condition that can occur after surgery, where an abnormal collection of blood vessels forms. Although the ultrasound findings do not suggest a vascular malformation, it's essential to consider this diagnosis, as it can lead to significant morbidity if not diagnosed and treated.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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