Because the periosteum is heavily innervated, mechanical vibration over a fracture site stimulates the overlying periosteum, causing pain. 2 The pain stops or decreases with the removal of the tuning fork.
In fact, implants can irritate overlying soft tissue and cause pain, requiring a second surgery to remove the implant.
Clinical presentation includes local pain, swollen oedematous or gangrenous overlying skin, sometimes with appreciable crepitus, and progressive hyperthermia.
Patients may experience pain secondary to a direct mass effect on the overlying soft tissue, mechanical trauma or an inflamed bursa overlying the lesion.
The clinical picture varies: more than 95% of patients experience fever, and 80% have arthralgia or myalgia that typically follows a centripetal migratory path; abdominal pain occurs in 80%; and skin manifestations, including erythematous rash, oedematous plaques (often overlying areas of mylagic pain), and discrete reticulate or serpiginous lesions, occur in 70% of patients.
Flares were defined as acute episodes of joint swelling, pain, exquisite tenderness and warmth, and redness at the joint, along with the overlying skin being tense, warm, shiny, and purplish or red in color.
These reports suggest that TMD pain causes an overall increased sensitivity to varying types of superficial stimuli applied to the overlying facial skin [ 5].
Though our patient was asymptomatic, GISTs usually manifest with nonspecific symptoms, such as nausea, vomiting, abdominal pain or, most often, with bleeding, due to protrusion of the tumour and stretching of the overlying mucosa; metastasis may sometimes constitute the initial symptom [ 8, 9].
Pain can often limit the extent of compression of the abdominal wall, thus limiting the ability to displace the overlying bowel loops.
The viewer is not drawn in but driven back by the glassiness of the overlying grid.
