Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
195 Doctors are Online

Horizontal divot in thigh muscle, discolouration on surface, bruise. Is it serious? Whats the diagnosis?

User rating for this question
Excellent
Answered by

Orthopaedic Surgeon
Practicing since : 2000
Answered : 170 Questions
Question
I inadvertently discovered (when "feeling" to see if I'd lost any fat on my hips) an approx 4cm horizontal and 1-1.5cm vertical "divot" in the high muscle about 7cm below the top of my pelvic crest in my lower back. It is in an almost straight horizontal line about 5+cm just slightly above and to the left of the existing left dimple many of us have on either side of the spine.

I have no idea whether it's new or not--but feel it hasn't always been there, altho I rarely feel that area of muscle/fat. The divot isn't visible (that I can tell) on the surface like the dimple, but is certainly felt when the area is pressed. There may be a slight discoloration on the surface, like a fading bruise which might be from my pressing on it several times, but there's really no tenderness. However, I'm very conscious of a slight sensation there after I've felt it for these measurements. I don't remember bumping this area at all, certainly I'd remember if it were hard enough to creat this divot.

Naturally, I'm concerned because I know it wasn't there the last time I felt that area--altho that might have been several years ago. I know there's likely no specific diagnosis, but could someone offer me possibilities? More than anything, can it be a sign of something serious? (I have nothing else like this anywhere on my body.) ** In May, just had a CT scan from chin to pubic bone--non-remarkable.**
Posted Sun, 8 Jul 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Atul Wankhede 12 hours later
Dear user,
Thanks for posting your query.

Its difficult to diagnose without physically examination, but we'll try. We first need to determine the nature of the swelling, for which I request you to answer the following questions-

1. Consistency- soft/firm/hard ?
2. Mobility- if you are able to move it in a vertical or horizontal fashion.
3. Local warmth- if the skin over the swelling is warm to touch.
4. Pain- if its painful on hard press.
5. apart from slight discoloration over the skin, do you find any puckering of skin?
6. Any difficulty in walking/moving your legs/sleeping/sitting?

In all, it doesn't seem serious at all. It could be a simple Lipoma or a neurofibroma. Nevertheless we must take all necessary steps to evaluate it, physically and radiologically. If you must, get an x XXXXXXX (to rule out bony lesion) or a sonography (for soft tissue lesion).

I shall await your response.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Horizontal divot in thigh muscle, discolouration on surface, bruise. Is it serious? Whats the diagnosis? 6 hours later
I appreciate your offer for more information. It seems that my use of the word "divot" has caused confusion. If you don't play golf, you probably don't have reason to know what I mean. A divot is when the golf club strikes the ground and takes out a piece of sod/clump of grass--leaving the "hole" where the grass was.
So, instead of this area being a swelling, it's the opposite--it's as if a wedge of the muscle has been cut out (in the size described) or is missing.
On re-inspection, there is no discoloration, no bruising (any I saw yesterday must have been from my repeated pressing). There is no warmth, puckering or tenderness but there is a slight depression visible on the skin surface almost identical to the two dimples some of us have on either side of the spine just below the waist.
There is no restriction of movement--altho other than twisting--I don't know how this particular muscle across the high back portion of my pelvis would "move XXXXXXX There's no discomfort or restriction with twisting and actually no tenderness or discomfort with pressing it. It just feels like part of the muscle has been "cut" away.
I did just have a full trunk CT scan which was unremarkable.
Sorry for the long details. I appreciate the opportunity for your opinion under these limited circumstances.
Follow-up: Horizontal divot in thigh muscle, discolouration on surface, bruise. Is it serious? Whats the diagnosis? 2 hours later
I just rec'd an email that you had answered my question (approx 1-1:30pm EDT). I see your first answer which ask me questions, but I don't see a "final" answer to my answers. I refreshed the page, but don't see a second answer.
 
 
Answered by Dr. Atul Wankhede 1 hour later
Dear user.
Please accept my apology for having confused a divot to a swelling. I appreciate the finer details you posted.

The dimpled parts you mentioned just below the waist are known as the dimples of venus, adjoining which are the attachments of certain spinal muscles and origins of certain pelvic muscles. A depression approximately 5 cm above and left can only be superficial spinal muscles. It could be just a simple muscle atrophy (loss of muscle mass-normal aging process) causing inward depression of normal tissue, or just gradual loss of body fat that's otherwise normally present at that site.

A CT if revealed no bony abnormality is a good sign. And no pain, loss of functionality, disturbance in routine activity shows that its not a serious lesion, or a lesion at all.

If there is any discomfort here on, remember to get an MRI done. It not only shows bony structures, but muscles nerves and vessels too. That shall reveal if there's any abnormality in any of those.

I hope this answers your question and once again forgive me for the misunderstanding before.
Regards.
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Medical Topics

The user accepted the expert's answer

Ask an Orthopaedic Surgeon

©2014 Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions