Symptom Finder - Crepitus
CREPITUS
In deciding what the cause of crepitus is, first think of what substances may be involved. There are three: gas, fluid, and bone. Next, visualize the anatomy of the area. If the crepitus is over a joint, it is most likely fluid in the joint or bursa, but it may also be loose bone or cartilage fragments. If the crepitus is over one of the long bones of the extremities, it may be due to a fracture, gas gangrene, or a bone tumor that has eroded the bony cortex. If the crepitus is over the lung, one has to consider the possibility of subcutaneous emphysema due to pneumothorax in addition to a fractured rib. Subcutaneous emphysema may also occur over an orbital fracture that has penetrated the maxillary or frontal sinus and around a tracheotomy site. Crepitus in the neck may also result from a ruptured esophagus, trachea, or major bronchus.
Approach to the Diagnosis
Plain films of the area involved will identify subcutaneous emphysema, gas gangrene, fractures, and arthritic causes. Bone scans or CT scans help to identify bone tumors, fractures, and joint pathology in elusive cases.
Arthroscopy is extremely valuable in diagnosing joint pathology. An orthopedic consultant should be consulted.
CREPITUS
In deciding what the cause of crepitus is, first think of what substances may be involved. There are three: gas, fluid, and bone. Next, visualize the anatomy of the area. If the crepitus is over a joint, it is most likely fluid in the joint or bursa, but it may also be loose bone or cartilage fragments. If the crepitus is over one of the long bones of the extremities, it may be due to a fracture, gas gangrene, or a bone tumor that has eroded the bony cortex. If the crepitus is over the lung, one has to consider the possibility of subcutaneous emphysema due to pneumothorax in addition to a fractured rib. Subcutaneous emphysema may also occur over an orbital fracture that has penetrated the maxillary or frontal sinus and around a tracheotomy site. Crepitus in the neck may also result from a ruptured esophagus, trachea, or major bronchus.
Approach to the Diagnosis
Plain films of the area involved will identify subcutaneous emphysema, gas gangrene, fractures, and arthritic causes. Bone scans or CT scans help to identify bone tumors, fractures, and joint pathology in elusive cases.
Arthroscopy is extremely valuable in diagnosing joint pathology. An orthopedic consultant should be consulted.
