Skin conditions and other underlying issues
The following are possible conditions that may cause raised areas over the shoulder:
- Lipomas - these are adipose/fat cells that accumulate under the skin and form spongy to semi-hard masses that produce the appearance of a lump located under the skin. These are benign masses and are not cancerous in any form, nor do they become cancerous. They may have to be surgically removed if they are aesthetically displeasing or if they cause pain or discomfort, otherwise, they are left alone.
- Foreign objects - the affected person will usually complain of having worked with steel or metalwork or may have been felling trees before they noticed any bumps on their shoulders due to possible foreign objects entering the soft tissue. Sometimes, these masses may appear over time due to a chronic inflammatory response of the body in the case of a foreign object having been embedded in the soft tissue for a long period of time. X-rays may confirm the presence of a metal or wood foreign body in the soft tissue which will then be surgically removed under local anesthesia.
- Abscess - pus can build up in an area where an acute infection is taking place. If the area cannot drain by itself, then the pus (dead white cells) will accumulate and form a fluctuant mass under an area of infection. This condition may be confirmed clinically or by removing some fluid using a needle and syringe. When an abscess is confirmed, it can be drained under local anesthesia or general anesthesia if the mass is large.
- Other soft tissue masses - soft tissue masses that are not characteristic of lipomas have to be investigated further to rule out any problematic issues. An MRI scan of the shoulder will be performed to assess what is normal and abnormal tissue and the patient will be referred to a specialist to have a biopsy taken of any suspect tissue. This will also help determine the correct course of treatment.
Patients who give a history of sustaining trauma and who present with lumps and bumps over the shoulder area need to be managed urgently.
The following are examples of possible injuries that may be sustained:
- Soft tissue swelling - some injuries to the shoulder as well as repetitive motions will result in injury to the muscles and tendons of the anatomical area resulting in swelling of the tissue. Usually, X-rays or even ultrasounds are performed to rule out fractures and torn ligaments. Mild injuries will be managed conservatively and more severe ones will be treated further by relevant specialists such as orthopedic surgeons.
- Fractures - a break in the bone of the head of the shoulder (glenoid), the collarbone (clavicle), or front of the shoulder blade (acromion) may all result in deformities around the shoulder area. Abnormally raised or protruding bumps may be visible and the exact fracture will need to be confirmed by performing an X-ray of the shoulder. Depending on the severity of the fracture, the patient may be managed with a cast being applied or may have to undergo surgical management.
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