Painful Hard Lump on the Fifth Metacarpal

Fifth metacarpal of the right hand?

Hello doctor, I have a hard lump on the fifth metacarpal of my right hand, and it hurts when I press on it! Last year, I got angry and hit the wall, and it swelled up.
I had an X-ray done at that time, and it showed nothing wrong.

Nìmíng, 30~39 year old female. Ask Date: 2023/07/12

Dr. Chen Bochen reply Orthopedics

Thank you for sharing your experience.
With more heat therapy and stretching exercises, the pain will subside in a while.

Reply Date: 2023/07/12

More Info

Understanding a painful hard lump on the fifth metacarpal can be concerning, especially given your history of trauma from hitting a wall. The fifth metacarpal is the bone in your hand that supports your little finger, and injuries or conditions affecting this area can lead to various symptoms, including pain, swelling, and the formation of lumps.

Given that you experienced swelling after the incident and had an X-ray that showed no fractures, it is possible that the lump you are feeling is a result of soft tissue injury or a bone contusion. Soft tissue injuries can lead to the formation of a hematoma (a localized collection of blood outside of blood vessels) or scar tissue, which may feel hard to the touch. These types of injuries can sometimes take a long time to heal completely, and residual pain or lumps can persist even after the initial injury has resolved.

Another possibility is the development of a ganglion cyst, which is a fluid-filled sac that can form near joints or tendons, often in the hand or wrist. Ganglion cysts can be painful, especially if they press on nearby nerves or structures. They are generally benign and may fluctuate in size. If the lump is indeed a ganglion cyst, it may require monitoring or, in some cases, aspiration or surgical removal if it becomes bothersome.

Additionally, conditions such as tenosynovitis (inflammation of the tendon sheath) or arthritis could also lead to similar symptoms. Inflammatory conditions can cause swelling and pain, and they may present as a hard lump if there is significant swelling or joint effusion.

To further evaluate the lump, consider the following steps:
1. Consult a Specialist: It would be advisable to see an orthopedic specialist or a hand surgeon who can perform a thorough examination. They may recommend imaging studies, such as an MRI or ultrasound, to better assess the soft tissues and determine the nature of the lump.

2. Pain Management: If the lump is painful, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and reduce inflammation. However, it’s essential to follow the recommended dosage and consult with a healthcare provider if you have any underlying health conditions.

3. Physical Therapy: Depending on the diagnosis, physical therapy may be beneficial to improve mobility and strength in the hand while addressing any underlying issues related to the injury.

4. Monitor Symptoms: Keep track of any changes in the lump, such as size, pain level, or any new symptoms. If the lump becomes larger, more painful, or if you experience decreased function in your hand, seek medical attention promptly.

In summary, while the hard lump on your fifth metacarpal may be related to your previous injury, it is essential to have it evaluated by a healthcare professional to determine the exact cause and appropriate treatment. Early intervention can help prevent further complications and ensure optimal recovery.

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Understanding Painful Hard Lump on the Fifth Metacarpal

Hello doctor, I have a hard lump on the fifth metacarpal of my right hand that hurts when pressed! Last year, I got angry and hit the wall, and it swelled up. I had an X-ray done at that time, and it showed nothing wrong.

Dr. Chen Bochen reply Orthopedics
Thank you for sharing your experience. Applying heat and doing stretching exercises will help alleviate the pain, and it should subside after a while.

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