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What does a painful hard lump on the scapula indicate?

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General & Family Physician
Practicing since : 2009
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I have a painful, hard, unmovable lump on the edge my right scapula, I noticed it about a week ago. It seems to have remained the same in size about 1.5 inches long x 0.5 inches wide. It is most certainly attached to or part of the acromion process and solid not adipose tissue or part of the muscle (i.e.pulled muscle or strain). Initially, it presented as just a small area tender to the touch, but has progressed to actual pain upon moving my right shoulder or arm. I have recently been ill (cold and flu like s/sx) going on approx 3 weeks, and everything I read has led me to believe this may potentially be osteomyelitis. I'm a 46 year old nurse and realize I probably need to head to my doc for tx (antibiotics) addressing the ongoing upper respiratory infection issues. As many health professionals, I hate seeing my doc for unnecessary reasons i.e... a cold. However, this illness has continued for what seems like forever and has s/sx I don't usually exhibit such as ongoing severe nausea, in addition to the upper respiratory infection s/sx and now this. It's a Sunday (Superbowl Sunday) and knowing nothing about osteomyelitis, I would just like to hear the thoughts of a Dr. before considering a trip to the docs office. Thanks so much
Posted Sat, 1 Mar 2014 in General Health
Answered by Dr. Chobufo Ditah 2 hours later
Brief Answer: Unlikely to be osteomyelitis Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about these symptoms and all the disturbing thoughts that have been going through your mind. I hope together we would be able to approach this, identify the cause and establish a treatment plan to help you overcome this. From the description of your symptoms, this is very unlikely to be osteomyelitis. Bone infections would not present with a palpable mass on the surface. They often develop over weeks and the pain is a diffuse bone pain. Abscess located in the bone never really have the possibility to increase in size to the extend of becoming palpable on the surface unless in severe bone complications which is exactly not the case with you. The description of your symptoms is suggestive of costochondritis. This is inflammation of cartilage that joins chest bones to the sternum most often following a viral upper respiratory tract infection. This is usually a self limiting infection that need just pain medications to address it. However, it would be difficult to conclude on a specific diagnosis without a proper examination and some basic tests. We would need to do an erythrocyte sedimentation rate(ESR) and at a minimum an xray to try and understand what the exact nature of this. I don't think it would be a waste of time and resources consulting your doctor. This would enable the above examination and tests to be done. Depending on the initial findings, a management plan would be developed to address whatever the problem is. I hope you find this helpful.I wish you well.Thank you for using our services and please feel free to ask for clarifications and more information if need be. Dr. Ditah, MD.
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Follow-up: What does a painful hard lump on the scapula indicate? 10 minutes later
Chestbone to the sternum? It is located on the edge of the scapula not clavicle. Regardless, I believe this does warrant a trip to my doctor as you suggest, but seemingly not any type of emergent situation. Thank you for your insight, it was very helpful!!
Answered by Dr. Chobufo Ditah 28 minutes later
Brief Answer: Thanks for the clarification! Detailed Answer: Hi and thank you so much for this clarification. It escaped my mind it we were referring to the scapula and not the clavicule! sorry for that mix up. In any case, this is clearly not osteomyelitis. While the exact cause is pending investigations, I will lean more towards a reactive inflammatory response from the upper respiratory tract infection. For now, it does not warrant an ER visit but I will suggest you go in as soon as possible. Trying some anti inflammatory medications like Diclofenac and Tylenol would offer great relief. If you have never taken these before, please check with your doctor to make sure they are say for you. I hope this helps. Am again sincerely sorry for the mix up. Feel free to ask for more information or clarification if need be. Thanks. Dr. Ditah, MD.
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