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Lump under skin below knee cap after injury. Sore. X-ray clear. What could it be?

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I fell of my bicycle, landing effectively on the top of my tibia and lower knee cap. There was grazing (road rash) and bruising. It's all healing, but I'm left with a lump under the skin, just below the knee cap. It's quite hard and the size of a pea and is sore if I manipulate it. Nothing shows on an x-ray, so it's not gravel or a bit of chipped bone. What could it be please?
Posted Tue, 25 Sep 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Praveen Tayal 3 hours later
Hello,
Thanks for posting your query.
A hard swelling just below the knee can be due to a fibrozed hematoma or an inflammed bursa. The other causes can be a blocked sebaceous gland or a lipoma. A direct examination by a physician will help in confirmation of the diagnosis.
Most of the times such post traumatic swellings do resolve spontaneously after sometime without any treatment.
FNAC and MRI scan can help in confirmation of the diagnosis if needed.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.

Above answer was peer-reviewed by
 
Follow-up: Lump under skin below knee cap after injury. Sore. X-ray clear. What could it be? 42 minutes later
Given the lump is recent and occurred only after the fall, surely it can't be a blocked sebaceous gland or a limpoma (which I have had to look up as I had no idea what it is) or can it - I read they build up very slowly over time?

The lump can't be an inflamed bursa as there is no pain from it - or do you get painless, inflamed busae? It gets sore only when I push it around.

If it is a fibrosed hematoma, how long does the haemotoma take to fibrose after the injury? It is too painful to kneel on. How long is it likely to take to disperse? Is it likely to cause lasting damage if I don't have it treated?
 
 
Answered by Dr. Praveen Tayal 1 hour later
Hello.
Thanks for writing again.
Inflamed bursa and fibrozed hematoma are the most likely causes. Inflamed bursa can be diagnosed only on a MRI scan.
Usually hematoma gets fibrozed after 3-4 weeks of injury. It usually disperses on its own without any treatment in 4-6 months. It is not likely to produce any long term damage if left as it is.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Lump under skin below knee cap after injury. Sore. X-ray clear. What could it be? 1 hour later
If it's an inflamed bursa, what happens. Can my GP send me for an MRI scan or would I have to see a consultant? I have a number of episodes of trochanteric bursitis and the lump below my knee is not painful in the way that is. Why isn't this lump painful like that if it could be bursitis?
 
 
Answered by Dr. Praveen Tayal 9 hours later
You will have to consult a specialist for MRI.
Swellings due to bursa are not always painful. They do become inflamed from time to time.
You can do a hot fomentation till then to see if the swelling subsides.
Regards.
Above answer was peer-reviewed by
 
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