Managing a Persistent Lump After a Car Accident: Expert Advice Needed

There is a small lump on the superficial muscles of the upper posterior calf after a car accident. What should I do?

Hello Dr.
Wu, I have a small lump on the superficial muscles at the upper back of my calf, approximately 1 cm in diameter.
This lump is likely a remnant from a minor car accident I had on September 20th of last month.
At the time of the accident, I went to the emergency room to have my knee and elbow abrasions bandaged, and I informed the doctor that I had hit the upper back of my calf and felt some pain.
However, since there was no redness, swelling, or visible bruising at that moment, the doctor advised that it would heal naturally, and I went home.

The next day, I noticed that the skin on the upper back of my calf, about the size of a palm, had turned a light yellow, and I could feel a hard lump (about 2 cm) beneath the skin, with some bruising nearby.
I did not seek medical attention at that time, thinking it would heal as the doctor suggested.
About four weeks later, the pain and yellow discoloration resolved, but the hard lump remains, still about 1 cm in size (it does not hurt when pressed), and it feels like it has not decreased in size.

I would like to ask Dr.
Wu: 1) If I want to address the issue of the lump, should I see a dermatologist, a rehabilitation specialist, or another type of doctor? 2) I am a patient with ankylosing spondylitis and take two Salazopyrin and three fish oil capsules (total omega-3 of 1200 mg) daily.
Since starting Salazopyrin, my platelet count has decreased from 260,000-290,000 to around 230,000.
Is the reason I cannot heal naturally, leaving me with a lump, due to the Salazopyrin and fish oil lowering my platelet count and coagulation function, making me more prone to developing lumps from impacts compared to others? 3) Based on the brief description above, do you think I need surgery to resolve the lump? 4) Can self-massage or superficial electrical therapy at home help reduce the swelling? Thank you, Dr.
Wu.

Zheng, 20~29 year old female. Ask Date: 2023/10/31

Dr. Wu Yuxin reply Dermatology

It is possible that a hematoma in the subcutaneous tissue or muscle layer resulting from trauma has not been reabsorbed on its own.
While there is likely no immediate danger, it is still advisable to consult a surgeon to clarify the exact cause and receive appropriate treatment.

Reply Date: 2023/10/31

More Info

Dear Henry,
Thank you for reaching out with your concerns regarding the persistent lump on your calf following your car accident. Based on your description, it seems that you may be dealing with a hematoma or a localized area of fibrosis resulting from the trauma. Let’s address your questions one by one.

1. Which Specialist to See: Given the nature of the lump and its persistence, it would be advisable to consult with an orthopedic specialist first, as they can evaluate whether the lump is related to the underlying muscle or soft tissue injury. If they determine that the lump is more superficial or related to the skin, they may refer you to a dermatologist. A physical therapist could also provide insights into whether rehabilitation exercises might help reduce the lump.

2. Impact of Medications on Healing: You mentioned that you are taking Salazopyrin (Sazal) and fish oil supplements. Salazopyrin is known to have anti-inflammatory properties and can affect blood cell counts, including platelets. A decrease in platelet count can potentially lead to a higher risk of bruising and hematoma formation, which might explain why you developed a lump after the injury. However, it’s essential to discuss any concerns about your medications with your prescribing physician, as they can provide tailored advice based on your overall health and treatment plan.

3. Need for Surgery: Regarding the possibility of needing surgery to address the lump, it is difficult to determine without a physical examination and possibly imaging studies. If the lump is a hematoma, it may resolve on its own over time. However, if it is a fibrous tissue formation or if it is causing discomfort or functional limitations, surgical intervention might be considered. Your orthopedic specialist will be able to assess the lump's characteristics and advise you on the best course of action.

4. Home Management Techniques: As for self-management, gentle massage around the area may help improve circulation and reduce swelling, but be cautious not to apply too much pressure, as this could exacerbate any underlying injury. Superficial electrical stimulation (like TENS) can also be beneficial for pain relief and may aid in reducing swelling. However, it’s best to consult with a physical therapist before starting any home treatment to ensure it’s appropriate for your specific situation.

In summary, I recommend scheduling an appointment with an orthopedic specialist to evaluate the lump and discuss your ongoing symptoms. They can provide a thorough examination and determine if further imaging or treatment is necessary. Additionally, keep monitoring your symptoms, and if you notice any changes such as increased pain, redness, or swelling, seek medical attention promptly.

Take care, and I hope you find relief soon.

Best regards,
Doctor Q&A Teams

Similar Q&A

Managing a Persistent Lump After a Car Accident: Expert Advice Needed

Hello Dr. Wang, I have a small lump under the skin on the upper back of my calf muscle, approximately 1 cm in diameter. This lump is likely a result of a minor car accident I had on September 20th of last month. At the time of the accident, I went to the emergency room for bandag...

Dr. Wang Zhaomin reply Rehabilitation
This consultation platform cannot provide a diagnosis or treatment. Based on the description, it may be related to post-injury subcutaneous bleeding or fibrosis. The platelet count is still within the normal range and may not necessarily be related to the mass. Heat therapy and e...

Decades-Old Bump After Car Accident: Which Specialist to Consult?

Hello, doctor. I would like to ask, there is a lump at the site of a car accident from over ten years ago that has not resolved. It feels tingly and numb when touched, and there is a hard mass. Which specialty should I see, and what kind of treatment should I expect? Thank you.

Dr. Chen Jiaming reply Surgery
Based solely on your description, it is difficult to confirm whether it is scar tissue. If you wish to remove the scar tissue, you may consider consulting a plastic surgeon; however, factors such as your individual physiology and the location of the scar (whether it is under tens...

Should You See a Doctor for a Persistent Lump After an Injury?

Hello Doctor: I had a car accident a month ago and had an X-ray done, which showed no abnormalities in the bones. The bruising has subsided, but there is still a lump, and it still hurts when pressed. Should I go to a clinic or hospital to see a doctor?

Dr. Lin Zhebin reply Family Medicine
Hello: If the X-ray of your bones taken after the car accident showed no abnormalities and the bruising has disappeared, the painful lump you are pressing on may be due to a muscle contusion causing localized tightness and inflammation. It is recommended that you apply a warm com...

Managing Post-Accident Bruises and Lumps: What You Need to Know

My daughter had a car accident over a month ago. The bruising around her eyes and nose has faded, but there is still a hard lump about one centimeter in size that hasn't gone away. What should I do, doctor? Previously, we visited a clinic where the doctor mentioned it might ...

Dr. Lu Daokuan reply Plastic Surgery
If the blood clot is mostly absorbed, a large clot should have liquefied within a month. A 1 cm hard mass may be a localized fibrotic reaction following an injury, which typically softens gradually over 2 to 3 months.