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Lump between shoulder blades, ankle swelling, normal urine test, prescribed Synthroid. What is the cause?

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Orthopaedic Surgeon
Practicing since : 2011
Answered : 5141 Questions
I am 57 years old, 5'0 tall and 160lbs. I've gained at least 10 - 15 lbs this year without changing any eating habits. I do have hypothyroidism and my endocrinologist switched my medication to Armour from Synthroid about 9 months ago. When I just went in to be checked, he discovered a lump between my shoulder blades. I'm also having bad swelling in my ankles for several months now, and they are always hurting. The area between my shoulder blades has been so painful it is waking me up from sleep. My endocrinologist said he was testing me for elevated cortisol with a 24 hour urine test. I read the symptoms for Cushings and the symptoms seemed to be a perfect match, but I just found out today that the urine test was normal. My thyroid numbers were off and I am being switched back to Synthroid, and I assume that will help the weight problem (or explain the weight gain), but since I did not speak to the doctor, I have no idea what the cause can be for this painful lump and my swollen ankles. I don't know what to do from this point forward?
Posted Tue, 5 Jun 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Aashish Raghu 2 hours later
Hi there.

Thanks for the query.

Have you gained weight recently ?

Do you prefer cool or warm environmental temperature ?

Do you have constipation or loose stools ?

Has the swelling between the shoulder blades increased in size rapidly in a few weeks or a few months to years ?

Do you sweat excessively, have tremors of hands, feelings of anxiety and nervousness, decreased sleep ?

According to your history, the symptom of swollen ankles can be attributed to hypothyroidism because your thyroid levels were not under control. On the other hand if you were over medicated with a high dose of Thyroid medication you could have developed hyperthyroidism and this may have also caused swollen ankles.

Kindly provide your latest thyroid hormone values for me to be in a better position to help you in this regard.

Swelling between shoulder blades is less likely due to Cushing's disease since it is associated with severe disturbing pain. More likely causes are fat cyst or lipoma, connective tissue swellings like fibromas, neuromas etc. I would suggest you to get the swelling examined by a General Surgeon who will be better trained to examine and decide the diagnosis and management.

Kindly keep your thyroid levels in regular monitoring and within normal levels as much as possible. Eat a balanced diet. Drink 1-2 litres of water day. Do daily brisk walking for 40 minutes a day. This will help maintain normal hormonal balance and facilitate in weight loss as well. Avoid fatty or junk diet, colas, caffeine, smoking ro alcohol.

Kindly answer my queries.

I hope I have answered your query. I will be available to answer your follow up queries.

Wishing good health.


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