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What causes painful lump just below collar bone on right side?

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Posted on Mon, 25 May 2015
Question: I have a very, very painful lump that is just below my collar bone on the right side. It has gotten progressively worse over last 4 days, and is now so painful I can not take a deep breath, and if I move my right arm the wrong way the pain is excruciating. Just thought it was muscle strain since you have muscle that covers your breast bone, but now I have a very obvious lump.
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Answered by Dr. T Chandrakant (46 minutes later)
Brief Answer:
CT scan and investigations are very important.

Detailed Answer:
Hi.
Thanks for your query and an elucidate history.

To Recapitulate: you have a developing painful lump just below collar bone on right side - progressing over 4 days - So painful that you can not take deep breath / or move right arm the wrong way - now have a lump.

May I please know a few more details please:
Any history of trauma ?
Any associated fever, chills, coughing ?
Any past history of tuberculosis or any other problems?

Coming back to the points:
This looks to be a developing or developed abscess.
I would advise you the following:
- Consult a General Surgeon / Go to ER
- You need a CT scan of the area, neck and chest to see whether there is liquefaction or not, whether there is associated extension to or from the bones/ lungs or any other structure to take further steps.
-Antibiotic and anti-inflammatory cover.

I hope this gives us an insight of the problem and until it is decided on CT do not allow them to put an incision or so.
- FNAC (fine needle aspiration cytology) can be performed and helps in diagnosis- if pus is aspirated it will be sent for gram staining, culture and sensitivity.
- If the aspirate is cellular it will be sent for histopathology.

I hope this answer helps you for a proper diagnosis and further management which is very important in lumps at such places.
Please feel free to ask further relevant queries if you need to or if you feel that there is a gap-of-communications.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. T Chandrakant (16 minutes later)
I have not had any trauma, no coughing or chills. No history of TB.
The only other thing I have had out of ordinary is swelling in my lower legs knees and ankles, some days much worse than others. Always much better in the morning but back again at night to some degree or another.
The pain in my chest started Wednesday morning, I simply woke up with it and every day has gotten worse.
Raised area is noticeable to others too, not just me. Did not start out raised up like it is now.
doctor
Answered by Dr. T Chandrakant (15 minutes later)
Brief Answer:
Get the investigations and management as discussed.

Detailed Answer:
Thanks for your feedback.
Your history noted,
The cause of the swelling in the lower limbs may not be associated with the present problems.

Please get the CT scan as all the management as already discussed.
ASAP please.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19103 Questions

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What causes painful lump just below collar bone on right side?

Brief Answer: CT scan and investigations are very important. Detailed Answer: Hi. Thanks for your query and an elucidate history. To Recapitulate: you have a developing painful lump just below collar bone on right side - progressing over 4 days - So painful that you can not take deep breath / or move right arm the wrong way - now have a lump. May I please know a few more details please: Any history of trauma ? Any associated fever, chills, coughing ? Any past history of tuberculosis or any other problems? Coming back to the points: This looks to be a developing or developed abscess. I would advise you the following: - Consult a General Surgeon / Go to ER - You need a CT scan of the area, neck and chest to see whether there is liquefaction or not, whether there is associated extension to or from the bones/ lungs or any other structure to take further steps. -Antibiotic and anti-inflammatory cover. I hope this gives us an insight of the problem and until it is decided on CT do not allow them to put an incision or so. - FNAC (fine needle aspiration cytology) can be performed and helps in diagnosis- if pus is aspirated it will be sent for gram staining, culture and sensitivity. - If the aspirate is cellular it will be sent for histopathology. I hope this answer helps you for a proper diagnosis and further management which is very important in lumps at such places. Please feel free to ask further relevant queries if you need to or if you feel that there is a gap-of-communications.