Human activity is always closely connected with a variety of physical activities. Most people, while performing professional duties or playing sports, are faced with the need to lift and move heavy objects. Such physical activity can be the root cause of various pathological changes, degenerative processes, and diseases.
One of the vulnerable parts of the body is the shoulder joint, which provides functional mobility of the arm. It is on this area that a significant load is often placed, which is why cases of overexertion and damage to this part of the body arise, as well as the appearance of various neoplasms, for example, a subcutaneous lump on the shoulder. You should definitely pay attention to such manifestations, as this may indicate the active development of pathology in the body.
Subcutaneous lumps on the shoulder can occur for a variety of reasons, including: blockage of skin glands, changes in the structure of connective tissue, hematomas due to injury, malignant formations.
Hygroma
In most cases, a lump that appears on the shoulder is a hygroma. It is a kind of formed swelling, which is formed as a result of excessive accumulation of exudate of a serous-mucosal nature in the periarticular cavity or the cavity of the synovial bursa. That is, the resulting lump under the shoulder is a relatively safe hernia, the location of which is the synovial bursa of the joint.
Externally, the hygroma may have a round, clearly formed or irregular shape. When palpated, you can find that its structure is hard (dense) or soft. It is important to note that such a lump on the shoulder under the skin looks quite scary, but despite this, it is a benign neoplasm. Timely therapy and careful observation will allow you to get rid of it completely and without consequences.
The initial stage of development of hygroma (the appearance of a lump) is most often not accompanied by severe symptoms. The patient usually does not experience any discomfort or pain. In this regard, treatment of the disease is often delayed. But under no circumstances should you do this. It is necessary to consult a doctor at the first manifestations of a neoplasm.
It can be localized in different parts of the body, but, as a rule, it appears in the area of the shoulder joint. It should be noted that the appearance of a bump on the shoulder, a photo of which you can see later in the article, is only a symptomatic manifestation of destructive processes occurring and occurring in the patient’s body, the cause of which may be a previous disease.
Exostosis of the humerus: what is it?
Exostoses are osteochondral growths on the surface of tubular, less often flat, bones. They can reach large sizes and grow on a stalk or a wide base. Exostoses are formed from cells of the epiphyseal plates, i.e., the growth zone that ensures the systematic elongation of bones in children and adolescents until the end of the period of skeletal formation. Initially, they are formed by cartilaginous tissue, which gradually ossifies and transforms into spongy bone with unevenly distributed beams. The ossified growth is crowned with a so-called cartilaginous cap. Its thickness usually does not exceed 1 cm.
A cartilaginous cap with a thickness of more than 2 cm is an alarming sign, as this is typical for malignant tumors.
Exostosis of the humerus is the second most common osteochondroma. It accounts for about 10-20% of cases of diagnosing benign osteochondral neoplasms. The humerus is a long tubular bone. By the time the child is born, the proximal (upper) epiphysis, which forms the shoulder joint, is formed by cartilage tissue. It is in this part that exostoses are most often subsequently discovered, which causes the appearance of characteristic symptoms that force patients to consult a specialist.
Their appearance can be triggered by:
- habitual dislocation of the shoulder joint;
- deformation of the articular labrum;
- various types of injuries, including soft tissue bruises and fractures.
Also, the tendency to form osteochondral growths can be genetically determined and transmitted to the child from parents in an autosomal dominant manner. In this case, osteochondroma of the humerus is most often diagnosed during the period of active growth of the child, i.e. at 8-16 years.
Reasons for appearance
The main reasons causing the formation of hygroma and the appearance of a lump are considered to be the following:
- Damage to the shoulder joint by infection. It may occur due to undertreatment of other diseases.
- Prolonged mechanical impact or pressure on the joint.
- Excessive load on arms and shoulders.
- Continuous physical activity.
- Various traumatic injuries (fractures, bruises).
- Tendonitis (inflammatory processes affecting the tendons).
- Bursitis (inflammatory processes affecting the synovial bursa).
Along with this, local swelling in the shoulder joint may occur due to the development of anatomical deformation in the structure of the shoulder due to a hereditary predisposition.
Symptoms
If osteochondroma is small in size, grows slowly in accordance with the development of the skeleton and does not affect nerve trunks or blood vessels, it may not manifest itself in any way. Symptoms most often occur when exostosis of the shoulder joint is formed, i.e., a neoplasm is present directly in the area of the bone articulation. This is due to impaired trophism (nutrition) and neurological disorders due to irritation of the neurovascular bundle located right there. In such cases, you may experience:
- dull pain in the shoulder area that appears when moving the arm, especially with a large amplitude;
- feeling of stiffness in hand movements in the morning;
- limited mobility of the shoulder and upper limb;
- pain shooting from the shoulder to the forearm, hand, fingers, resulting from irritation of the brachial nerve;
- decrease in muscle strength and volume.
If such symptoms occur, you should consult an orthopedist. Bone exostosis of the humerus is diagnosed by palpation of the shoulder and X-ray examination. But if the neoplasm has not yet had time to ossify, it may not be palpable and remain invisible on x-rays. In such cases, MRI is indicated. The method allows you to detect even cartilaginous tumors, evaluate their structure, and also accurately measure the thickness of the cartilage cap.
It is important not to ignore the symptoms of humeral exostosis, especially in children. Neoplasms of this kind can cause arm curvature and increase the risk of fractures. There is also, albeit minimal, the likelihood of malignancy, i.e. malignancy of osteochondroma. With single benign osteochondral neoplasms, this is observed in no more than 1% of patients. But with rapid growth, detection of a cartilaginous cap with great thickness, and other controversial cases, a biopsy is indicated to accurately determine the nature of the tumor.
Symptoms of the disease
Most often, the initial stages of this disease are characterized by the appearance of only external manifestations. A lump that appears on the shoulder does not cause discomfort, does not hurt, and does not provoke swelling. The local temperature also does not increase.
As the pathological process develops, the symptoms begin to become serious. For example, the skin in the area of the neoplasm thickens over time and becomes red. In some cases, severe peeling of the skin is observed. Sometimes the lump on your shoulder hurts. How does this manifest itself?
Causes of bumps and additional signs
Lumps, balls, lumps under the skin - this is a common problem that almost everyone faces.
If you find a lump in the shoulder muscle, you should not panic. Such a violation can be provoked by banal physical fatigue. Sometimes bumps occur in people engaged in heavy physical labor. But most often the seal is formed as a result of injury or bruise.
Hygroma
Skin diseases are considered the most common causes of small bumps on the shoulder in a child or adult. In terms of the number of cases, the leader is hygroma - a pathology that occurs mainly in the area of the forearm and lower part of the shoulder.
The disease is a benign neoplasm and is associated with a disorder in the structure of the tendons. The hygroma gradually increases and in the final stages can cause severe discomfort. But sometimes it goes away on its own. The reasons for the violation include:
- inflammation in joints and tendons;
- frequent injuries to the area where the growth occurs;
- genetic predisposition;
- relapse with incomplete removal of the hygroma membrane;
- regular and monotonous loads on the joints;
- specific superficial position of the tendons.
Symptoms include: a small tumor that matches the skin tone, is located next to the tendons, and increases after exercise. Sometimes hygroma is accompanied by redness and peeling. With large sizes it begins to hurt, tingle and go numb.
Lipoma
Lipoma is a benign neoplasm that develops in fatty layers.
Lipoma is a wen. The ball forms in the hand on the shoulder or below, does not hurt, does not cause discomfort. However, it can increase greatly over time. Causes of lipoma include:
- obesity;
- polyps in the intestines;
- liver diseases;
- genetic predisposition;
- diabetes, thyroid pathologies and other diseases of the endocrine system;
- renal dysfunction;
- parasites;
- persistent injuries to the same area of the shoulder;
- intoxication of the body.
Lipoma is characterized by a round shape, soft texture and absence of inflammatory processes. On palpation, small lobules of tumor can be seen. It also retains mobility and does not exceed 2-3 cm in size.
In rare cases, several lipomas appear at once. This condition is caused by genetic disorders - Madelung syndrome and Dercum's disease. With these pathologies, many bumps appear, symmetrical to each other. With Dercum's disease, the bumps become painful. Women are more often affected.
Atheroma
Atheroma is a cystic formation of the sebaceous glands.
Atheroma is a cyst of the sebaceous gland, which can be congenital or acquired. Often occurs after acne. With atheroma there are the following symptoms:
- flesh or yellow tint;
- round form;
- elastic structure;
- without pain;
- slow development;
- mobility;
- it is possible to release a milky-colored substrate.
Unlike lipoma, atheroma can fester and has a harder texture. Firmly adheres to the skin. When infected, inflammation and pain occur.
Hematoma
A hematoma is characterized by pain, swelling on the shoulder, and discoloration. May have a black-blue tint, purple or rich red. Often accompanied by swelling and hardening of the skin. The only reason is mechanical damage and shock. In rare cases, hematomas can be a sign of the development of dangerous pathologies of the blood vessels and circulatory system. With frequent hematomas, the formation of fibroids is possible.
Malignant tumors
With the development of malignant processes, a swelling or lump on the shoulder is accompanied by a number of special signs:
- Slow but steady growth of compaction. The patient gradually feels weak, deteriorates in health, and unreasonable increases in temperature are possible.
- Cancerous tumors often do not have smooth borders or boundaries, but in the early stages even a small spot may not manifest itself in any way.
- Fever often occurs, the patient loses appetite, weight, and possibly enlarged lymph nodes.
- The seal is motionless, and palpation often causes discomfort.
Advanced stages of the oncological process are accompanied by bleeding and inflammation. In this case, a person’s temperature can always remain around 37.5 degrees.
If it hurts
If the disease that became the catalyst for the appearance of hygroma worsens, the lump quickly increases in size. It should be remembered that if the hygroma begins to hurt and cause discomfort, it means that an inflammatory or infectious process is actively developing in the body. In the absence of adequate therapy, serious complications can develop, including complete loss of arm mobility. Only a doctor should determine the tactics of therapy, individually in each case and taking into account diagnostic data.
Diagnosis of the disease
A lump on the shoulder, as a rule, is clearly visible, so almost any qualified doctor is able to establish the correct diagnosis through an initial examination and based on the collected medical history.
At the same time, it is important to understand that the tactics for eliminating a tumor will depend on the root cause of its occurrence. Moreover, not only an inflammatory focus, but also a serious injury can be localized in the shoulder area. The combination of such factors determines the need for comprehensive diagnostic measures.
As a rule, the following methods are used for diagnosis:
- Radiography. Allows you to determine the nature of the occurrence of existing processes, assess the integrity and degree of damage to bone tissue.
- Ultrasonography. Allows you to exclude some pathologies that have similar symptoms and assess the degree of narrowing of cartilage and joint spaces.
- Magnetic resonance, computed tomography. These techniques allow the specialist to obtain the most complete picture of the pathological process, which helps determine the localization of the root cause and determine the extent of damage to the shoulder joint. The results of MRI and CT can immediately confirm the suspected diagnosis and prescribe the necessary therapy.
- Laboratory examination of blood samples. This diagnostic study is prescribed to the patient in order to clarify the presence of purulent-inflammatory foci and determine the activity of infectious and inflammatory processes.
- Puncture of synovial exudate. This study allows us to obtain information about the degree of development of the inflammation process.
So, what to do if a lump appears on your shoulder.
Treatment of exostosis of the humerus
The only way to eliminate exostosis is surgery. It is shown when:
- deformities of the humerus;
- fracture of the base of osteochondroma;
- dysfunction of the shoulder joint;
- active growth of the tumor, which indicates a high risk of malignancy;
- diagnosing chondrosarcoma (malignant tumor);
- the appearance of signs of compression of vascular and nerve trunks (swelling of soft tissues, shooting pains, decreased muscle tone and volume, etc.).
If a neoplasm is discovered accidentally and does not bother the person, dynamic monitoring of it is sufficient.
If there are indications and no contraindications (purulent-inflammatory processes in the shoulder area, exacerbation of a chronic disease, acute respiratory infections), the date of the operation is planned. Previously, the patient must undergo training consisting of:
- radiographic assessment of bones;
- CT;
- UAC;
- OAM;
- biochemical blood test.
This data allows you to accurately plan the course of the operation, determine its scale, and also detect hidden contraindications. Direct removal of exostosis of the humerus is carried out mainly by performing marginal resection. The operation is performed under general anesthesia and the technique is relatively simple. The idea is to provide access to the tumor, remove part of the bone tissue with the growth and apply sutures.
Depending on the nature of the exostosis, resection can be carried out extraosseously and intraosseously, i.e. along the surface of the bone or with a recess inside it. Therefore, in some cases, bone grafting may be required to eliminate the defect formed after resection. To carry it out, grafts from the patient's own bone or artificial implants are used.
If exostosis of the humerus causes its curvature, a corrective osteotomy may be prescribed.
Therapy
If therapy for the tumor was started in a timely manner (at the initial stages of the development of the pathology), then the desired therapeutic result can be obtained with the help of conservative treatment. Taking into account the disease that provoked the appearance of a lump on the shoulder, treatment may include:
- Oral use of medications of various pharmacological groups (decongestants, anti-inflammatory, analgesics).
- Medicines intended for external use (warming bandages, medicinal patches, ointments, gels).
- Undergoing physiotherapeutic procedures.
- Use of lotions and compresses.
In some cases, patients are prescribed injections. According to experts, traditional medicine, used as the main method of therapy, is ineffective for hygroma. That is why they recommend combining it with drug treatment.
Diagnosis and treatment
In some cases, a doctor's consultation is necessary.
To determine the cause of the lump on the brachialis muscle of the arm from the shoulder, you need to visit a dermatologist or therapist. Next, the doctor will prescribe laboratory tests and instrumental examination: ultrasound, x-ray. In some cases, consultation with traumatologists, endocrinologists and other specialists is required, as well as an MRI or CT scan. To examine tumors with their contents, a puncture is prescribed. The same is done when studying pathologies associated with the state of the synovial fluid inside the joint cavity.
An integrated approach is used to treat skin diseases and tumors on the shoulders. It greatly depends on the cause of the pathology. Most often it is built on the following principles:
- Use of medications. Drugs aimed at eliminating the cause of the disease and symptomatic remedies are used. These could be NSAIDs, decongestants, immunosuppressants, vitamins.
- Use of gels and ointments. Particularly effective in the treatment of skin pathologies.
- Physiotherapy. Helps if the seal on the shoulder muscle is painful or inflamed. Electrophoresis, magnetic therapy, treatment with leeches, laser and UHF promote tissue regeneration and improve metabolism.
- Folk recipes. They are used in courses of 10-30 procedures over 2-4 weeks. Most often, lotions and compresses are made from dry herbs.
In severe cases, when a growth appears on the shoulder joint, injections are prescribed. They are made with NSAIDs, corticosteroids, vitamins, antihistamines and painkillers to relieve very severe pain.
Treatment of the initial stage of pathologies is easier and faster, patients recover fully. In advanced cases, treatment may take several months or more than a year.
Surgical intervention
In advanced cases, surgical intervention is required.
This method is used in advanced cases, when no conservative methods will bring relief. After excision of painful tissue and removal of growths, a rehabilitation period follows, during which the arm is completely immobilized. The operation is performed quickly and is well tolerated by patients.
To prevent the development of dangerous stages of tumors, lipomas, hygromas and other pathologies, if a lump appears on the shoulder, you should immediately consult a doctor. By following the recommendations, the patient will be able to completely forget about the problem within 2-3 months.
Surgical intervention
If the pathology is advanced, it may require its removal through surgery. Clinical practice and patient reviews show that removal of a lump on the arm on the shoulder is the fastest and most effective method of treatment. However, like other surgical operations, removal of hygroma is associated with a period of rehabilitation, which involves complete immobilization of the arm using fixing bandages.
By the way, judging by the reviews of patients, surgical removal is still preferable for many, since conservative treatment, as a rule, takes a long period and is not always effective. Many people prefer to fix the problem right away.
Rehabilitation
Discharge from the hospital after marginal resection is usually carried out after 3 days. Further recovery takes place at home, but does not imply significant restrictions. The sutures are removed within 7-10 days. After this, you can return to your daily duties.
All this time, the patient receives drug therapy designed to eliminate postoperative pain, accelerate tissue recovery and reduce the risk of complications.
Thus, exostosis of the humerus is a fairly common and relatively safe type of neoplasm. Its removal is indicated only if disturbances in well-being occur and consists of performing a technically simple and safe operation. Recovery after it is quick and easy, and relapses with proper surgical intervention are practically excluded.