Painful Hard Lumps on the Shin: When to Seek Help

A硬塊 the size of a 10-cent coin on the anterior aspect of the lower leg?

Dear Dr.
Hwang,
I would like to consult you regarding a hard lump the size of a 10-yen coin that I discovered on the front side of my calf about a month ago.
There was no trauma or impact, but it is painful.
I visited a surgeon who performed an ultrasound and stated that it is neither a cyst nor a tumor.
The doctor suggested that I monitor it for a month and prescribed anti-inflammatory medication.
However, this week I noticed that it has changed into three hard lumps the size of 1-yen coins, and they are still painful.
Should I see a surgeon again or consult another specialist?
Best regards,
Lisa

Ma, 30~39 year old female. Ask Date: 2005/06/02

Dr. Huang Ruiyun reply Dermatology

You can see a dermatologist.

Reply Date: 2005/06/02

More Info

Dear Lisa,
Thank you for reaching out with your concerns regarding the painful hard lumps on your shin. Based on your description, it seems you have already taken a proactive step by consulting with a surgeon and undergoing an ultrasound examination. The fact that the lumps have increased in number and size, along with persistent pain, warrants further evaluation.

When it comes to lumps or masses in the body, especially those that are painful and have changed in size or number, it is essential to consider a few factors. The initial assessment by your surgeon indicated that these lumps are neither cysts nor tumors, which is reassuring. However, the development of additional lumps and ongoing pain suggests that further investigation is necessary.

Here are some steps you might consider:
1. Follow-Up with Your Surgeon: Since your surgeon has already evaluated your condition, it would be prudent to return to them for a follow-up. They may want to perform additional imaging studies, such as an MRI, which can provide more detailed information about the soft tissue structures in your leg. This can help in identifying any underlying issues that may not have been visible on the ultrasound.

2. Consider a Referral to a Specialist: If your surgeon feels that the lumps require further investigation beyond their expertise, they may refer you to a specialist. Depending on the characteristics of the lumps, a referral to a dermatologist (for skin-related issues) or an orthopedic specialist (for musculoskeletal concerns) may be appropriate.
3. Monitor Symptoms: Keep track of any changes in the lumps, such as increased size, changes in color, or any new symptoms like fever or systemic symptoms (e.g., fatigue, weight loss). If you experience any of these, seek medical attention sooner rather than later.

4. Pain Management: Since you are experiencing pain, it is important to manage this symptom effectively. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help alleviate discomfort. However, consult with your healthcare provider before taking any medication, especially if you are already on anti-inflammatory drugs prescribed by your doctor.

5. Consider Other Causes: While your initial evaluation ruled out cysts and tumors, there are other potential causes for hard lumps on the shin, such as infections (like abscesses), inflammatory conditions (like bursitis), or even benign growths like lipomas. A thorough examination by a specialist can help clarify the diagnosis.

In summary, given the changes in your condition and the persistence of pain, I recommend that you seek further evaluation from your surgeon or a specialist. Early intervention can often lead to better outcomes, and it is always better to err on the side of caution when it comes to unexplained lumps or masses in the body.

Please take care, and I hope you find relief soon.

Best regards,
Doctor Q&A Teams

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