Painful Lump Near Ankle: Which Specialist Should You Consult?

You should see a dermatologist for a small hard lump that is painful when pressed?

Hello Dr.
Wang,
I previously had a job that required prolonged standing and walking.
One day, I experienced severe pain in the soles of my feet, feeling as if I was being stabbed with a knife with every step.
However, by the next evening, the pain had improved significantly, and by the third day, it was almost gone.
I was busy with work and didn't see a doctor at that time.

Last night, I suddenly noticed a small hard lump on my lower calf near the ankle.
It hurts when pressed, but it isn't particularly raised, and I'm not sure when this condition started.
I only discovered it last night because it was a bit itchy, prompting me to scratch and find the lump.
I did some online research and it seems related to myofascial pain syndrome, but I'm not certain.

Should I see a dermatologist or an orthopedic specialist? I am currently not engaged in any prolonged standing work; the job I had was only for a month, and it has been about half a month since I finished.
I'm not sure if that is related.

Thank you for your assistance, Dr.
Wang.

Lin, 20~29 year old female. Ask Date: 2021/12/19

Dr. Wang Jiacheng reply Orthopedics

It could be plantar fasciitis, which often causes pain due to prolonged standing and pressure on the soles of the feet.
You may want to consult an orthopedic specialist.
In the meantime, you can try using insoles to reduce pressure, minimize standing time, and apply heat to alleviate discomfort.

Reply Date: 2021/12/19

More Info

When dealing with a painful lump near the ankle, it's essential to approach the situation with a clear understanding of the potential causes and the appropriate specialists to consult. Given your description of the symptoms, including the sudden onset of pain and the presence of a hard lump that is tender to touch, there are several possibilities to consider.

Firstly, the pain you experienced in your foot, which felt like being stabbed, could be indicative of several conditions, including plantar fasciitis, tendonitis, or even a stress fracture, especially considering your previous job that required prolonged standing and walking. The subsequent appearance of a hard lump near your ankle could be related to muscle or tendon strain, inflammation, or even a benign growth such as a lipoma or a ganglion cyst.

In terms of which specialist to consult, it would be prudent to start with an orthopedic specialist. Orthopedic doctors specialize in the musculoskeletal system, which includes bones, muscles, tendons, and ligaments. They can evaluate your symptoms through a physical examination and may recommend imaging studies, such as X-rays or an MRI, to determine the underlying cause of the lump and pain. If the lump is related to a muscular or tendon issue, they can provide treatment options, which may include physical therapy, medication, or in some cases, surgical intervention.

If the orthopedic evaluation does not yield a clear diagnosis or if the lump appears to be more related to the skin, such as a cyst or other dermatological issue, then a referral to a dermatologist may be necessary. Dermatologists specialize in skin conditions and can assess whether the lump is a dermatological issue that requires treatment.

Additionally, if you suspect that your symptoms may be related to overuse or strain from your previous job, consulting a physiatrist (a specialist in physical medicine and rehabilitation) could also be beneficial. They focus on restoring function and may recommend rehabilitation strategies to strengthen the affected area and alleviate pain.

In summary, the best course of action would be to start with an orthopedic specialist, who can evaluate your symptoms in the context of your recent work history and the physical demands placed on your body. They can guide you through the necessary steps for diagnosis and treatment. If needed, they can refer you to a dermatologist or a physiatrist based on their findings.

It's important to address these symptoms promptly, especially since they can impact your daily activities and overall quality of life. Early intervention can lead to better outcomes and help prevent further complications. If you experience any worsening symptoms, such as increased pain, swelling, or changes in mobility, do not hesitate to seek medical attention sooner.

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