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Having painless lump and swelling on lower leg. X-ray and ultrasound done. How to get relief?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
My son has a painless lump on his middle lower left leg that we noticed a couple of weeks ago, he has had an x-ray and it said there was a soft tissue mass. He then had an ultrasound to further investigate and they determined it was a hemotoma (approx. 2cm across) . The issue I have is that my online research seems to say that they are usually associated with some pain and he does not have any??? Just wanting to make sure they are not overlooking something like a sarcoma. They say if it has not gone away in a month that he will have an mri.
Posted Tue, 7 Aug 2012 in Bones, Muscles and Joints
Answered by Dr. Hema Yadav 1 hour later
Thanks for posting your query.
Yes you are right in saying that most hematomas are painful because they represent injury or inflammation of the soft tissue involved.
In case your child has developed a gradual painless swelling on his leg without any definite history of trauma or external bruise and which is painless and progressive ( increasing in size then the best way to confirm the diagnosis is to get an MRI scan right away . Even a hematoma can be Confirmed and classified better on a MRI scan than an ultrasound .
Sarcomas of leg are less common rather rare tumors though it is a possibility and should be excluded in any child with painless progressive lumps in the lower extremities. Infact some may even be associated with hematoma or painful( if spreading internally ) .
The decision for further testing is taken by a doctor depending on the complete clinical history , examination of the swelling and the radiological features . Hence I assume that your doctor might have taken an appropriate decision.
But I would say you can always discuss it with his doctor and demand a more confirmatory test to be on the safer side.
Please do not panic as there is a possibility that the hematoma might be a long standing one in which the initial injury and pain might have been overlooked and a healing painless hematoma is being investigated .
Most hematomas may take weeks to a month for compete resolution hence your doctor has advised you for a wait and watch approach .
I understand your dilemma & so I would advise you to discuss your fears with the treating doctor to view things with a fresh perspective and come to a common conclusion.
Hope I have answered your query.
Kindly accept my answer if you have no further queries.
Wishing your child good health .
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