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Child having a bulge at the top of sternum, growing. What could this be?

Hi, my 10 yr old daughter has a bulge at the top of her sternum. When I feel it, it feels all hard like bone. She says that it s sore to touch and press on it. A few yrs ago, it was raised like this too. We had an X-ray done & they didn t find anything wrong. So I didn t pay much attention to it after that since they said it was fine. Well tonight she was coughing, which she has had for prob 6 wks now, and she put her hand on her upper sternum chest area & said she felt that it was much bigger than usual. That s when I looked at it and seen it was enlarged. I have a check up at the Dr office for her next week for and I m wondering if I should just have her Dr look at it then or if I should take her to our local hospital to have it checked out sooner? Any ideas on what this is?
Asked On : Fri, 23 Nov 2012
Answers:  2 Views:  101
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Pediatrician 's  Response

Thank you for your query.

From what you mention I understand that you can feel a bulge (which has enlarged since the last examination) above the sternal notch which is sore to touch. The bulge is hard like a bone and is associated with cough of probably 6 week duration. I would like to get the child clinically examined sooner for the swelling and chest and further investigate with:
1. X-ray chest AP & Lat. view
2. Ultrasound to know more details of the swelling (this shall be based on the clinical examination)
3. Further investigations, if required, like MRI.

It is very difficult to tell the cause of the bulge without a clinical examination as a number of structures are present above and behind the sternum near the sternal notch and swelling may arise from anyone of them. However the cough of 6 weeks duration suggests that something is pressing on the trachea/bronchus which may be initiating the cough reflex.

I hope I have answered your query to your satisfaction.

Wishing your daughter all the best.


Rajiv K Khandelwal
Answered: Fri, 23 Aug 2013
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