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Shoulder injury, have enlarged left clavicular lymph node. What is considered normal size of lymph node?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 9077 Questions

I injured my shoulder while body surfing and then aggravated the injury while canoeing a few weeks later. This resulted in two X-rays which revealed nothing. An MRI was ordered which revealed tendinitis of the rotator cuff and impingement. The MRI reviewer also noted a 6x8mm (.6 x .8 cm) mass that "appears likely" to be a lymph node. The Ortho referred me to a General Surgeon for further investigation with the note indicating Enlarged left clavicular lymph node.

My question is what is considered "normal" size of a left clavicular lymph node in a 44 year old male.

Let me mention that I am also diabetic type 2 taking
Lisinopril for HBP (40mg daily)
Crestor (10mg daily)
Fortamet/Metformin (1000mg daily).
last HG A1C = 5.6
Last normal full lab work up with Primary care physician no abnormalities(3/26/2012)

Since the shoulder injury I have been taking 1200 mg/day Ibuprofen (600 morning/600 night) and an over the counter sleep aid. I have no symptoms of illnes or pain other than the shoulder impingement.

Should I be concerned or this more of a CYA move from the physician. Don't get me wrong, I have read about the potential seriousness of the issue and will still follow-up with whoever I have to until a conclusion, bad or good, is made.
Posted Wed, 5 Sep 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 10 hours later
Thanks for posting your query.
Clavicular lymph nodes are usually 0.5 to 0.8 cm in size. The size that has been mentioned in the MRI is insignificant. Usually a lymph node less than 2 cm in size does not indicate a pathology.
In your case, since you are having tendonitis, the inflammation might have caused such a minor change in the size of the lymph node making it noticeable.
It is likely to subside once the inflammation subsides.
For shoulder impingement, you need to do regular physiotherapy once the acute pain subsides. Continue taking ibuprofen to reduce the inflammation.
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.
Dr. Praveen Tayal.
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