Lump on Shoulder: Causes, Diagnosis, and Treatment Options

Cysts and a Lump on Shoulder

An abnormal lump on the shoulder is a common ailment that is typically treated through medications, physical therapy, or surgery.

Our orthopedic doctors will work with you to alleviate pain and restore functionality as quickly as possible so you can resume leading an active life again.

A magnetic resonance imaging (MRI) scan revealed a soft tissue mass with heterogeneous signal intensity, suggesting fatty content, in the posterior shoulder. The mass was eventually identified as being caused by spindle cell lipoma.

Cysts

Cysts are closed sacs of tissue filled with pus, air, or fluid that contain pus. Different kinds of cysts can form around the shoulders and surrounding area such as epidermoid cysts, paralabral and ganglion cysts.

While usually unnoticed or treated directly, cysts may occasionally cause discomfort and limit movement.

A 19-year-old female patient presented to our clinic two months earlier complaining of right shoulder numbness and motion impairment without any trauma or aggravating activities.

After examination, it was diagnosed as compressive neuropathy of her axillary nerve and musculocutaneous nerve associated with an anteroinferior para labral cyst in her glenohumeral joint – an infrequent entity that rarely exhibits neurological symptoms; confirmation was achieved with an MRI which demonstrated its presence, expansion, as well as rising bubble sign identification – pathognomic for unicameral bone cyst of Tibia (Fig 2).

Paralabral cysts typically form on either side of a glenohumeral joint and may result from the extrusion of synovial fluid through labrocapsular tears in the glenoid labrum.

Herein, we present an anteroinferior paralabral ganglion cyst in a shoulder joint which compressed terminal branches of the brachial plexus, leading to compression of axillary and musculocutaneous nerves and leading to quadrilateral space syndrome.

After surgery, her clinical outcome and Constant score improved considerably.

Epidermoid cysts are a rare but disfiguring skin condition where small masses of semi-solid material, composed primarily of sebum and dead skin cells, form within or on the skin’s surface.

Epidermoid cysts commonly appear in areas like the earlobes, eyelids, neck, shoulder, or armpit.

Once applied with a numbing agent to the area concerned, scalpels are used to cut through its outer layer to open it by either using one straight cut down its center point or two oval cuts either way on either side of its center point – when open then, contents can be squeezed out, leaving only the cyst behind when removed with scissors or another instrument.

Importantly, cyst removal procedures should only be attempted under the care of a certified physician.

Squeezing, scratching, draining, opening (lance) or puncturing a lump can irritate it or inflame it further while pushing any infection deeper into the skin and possibly leading to severe bleeding.

If this does happen, wounds must be washed and dressed immediately to reduce further infection risks as repeated repetitive movement could exacerbate swelling and recurrence of cysts.

Abscess

Abscesses in the shoulder are unnerving. Most often caused by infection, they result in thick pus-like fluid accumulating inside the joint causing pain and swelling in its immediate vicinity, sometimes even leading to fever if severe infection spreads further afield.

Health care professionals often perform draining procedures on skin abscesses by cutting into them after first numbing it and sending samples of pus to be tested (called “bacterial culture”) at a laboratory, to ascertain which species of bacteria is causing the infection and which antibiotics might work best in treating it.

If you suspect that you have a subscapular abscess, medical attention must be sought immediately.

Early recognition and prompt surgical intervention using tendon-sparing approaches often leads to resolution.

Empiric antibiotic coverage for Staphylococcus aureus bacteria as well as MRSA should also be instituted immediately in high risk patients.

Arthritis

Arthritis is a group of conditions that impact joints. It begins by wearing away at the articular cartilage that allows bones to move smoothly, eventually leaving their rough surfaces to rub together painfully, leading to pain and stiffness in older people.

Osteoarthritis or degenerative joint disease typically strikes older individuals; however, this form can occur at any age due to various causes including rheumatoid arthritis, injuries or broken bones in the shoulder area.

Shoulder arthritis can take many forms and here are five major types:

Each type of arthritis manifests differently, but all share common symptoms: pain and swelling.

Swelling may come and go while pain usually worsens when moving the shoulder or may produce creaking sounds (crepitus). Doctors use physical exams to diagnose shoulder arthritis.

They will interview you about past health, and family history, as well as examine your shoulder for movement, swelling, and warmth.

Lipoma

Lipomas are benign tumors composed of fat cells. These slow-growing masses often appear on patients’ heads, necks, shoulders, and backs but may also show up in their thighs and abdomens.

Subcutaneous cysts are small and soft masses with a doughy texture that move when touched and can usually be moved with finger pressure without pain.

Lipomas in the shoulder typically cause no symptoms; however, they may become painful if they grow large or press on nerves in the area.

Ferrari et al reported on a 45-year-old woman who experienced symptoms of impingement due to an intramuscular suprascapular lipoma; their symptoms resolved after surgical removal of this mass.

Lipomas have the potential to transform into more dangerous forms of fatty tumors known as liposarcomas that tend to spread quickly, so your doctor may suggest further tests to rule out more serious health conditions.

Injury

The shoulder joint is composed of three bones – the humerus (upper arm bone), clavicle (collarbone), and their joint, called the acromioclavicular joint or ACJ.

If there is an issue at this point, this could cause an overlying lump to form on top of your collarbone or even cause weak, sore, or unstable shoulders to appear.

An unusual bump on your collarbone could be indicative of a separated shoulder injury, caused by stretching or torn ligaments connecting the clavicle and collarbone that were stretched or torn from falling or hard-hitting to the shoulder, such as due to falls or hits to this joint.

Treatment typically entails rest, pain medication such as NSAIDs, and gentle range-of-motion exercises under supervision by a physical therapist.

Knots

Many people experience knotted shoulders and neck muscles. Medical terminology refers to this form of tightness as myofascial trigger points (myo- meaning muscle; fascia being connective tissue that surrounds muscle fibers).

These taut muscle bands may cause pain, tenderness, and stiffness due to overuse, poor posture or emotional stress.

These shoulder knots may be painful or painless and appear as small pea-sized to walnut-sized nodules in your shoulder area.

Luckily, most knots can be alleviated with self-care such as applying pressure using hands or foam roller, getting professional massage treatment, performing specific exercises or trying acupuncture (an ancient healing practice using thin needles inserted into specific points in skin and muscle to relieve pain).

Acupuncture treatments typically produce minimal pain relief – you may only require several sessions before the shoulder knot has completely resolved itself!

Pimples or Warts

Most people associate acne with facial spots; however, acne can also occur on your shoulders if you wear loose, breathable clothing (Acne Mechanica).

This form of shoulder acne occurs when oil and dead skin cells build up on hair follicles or pores causing blockage; then bacteria like Cutibacterium acnes thrives off excess sebum-producing inflammation; while hormonal fluctuations, such as pregnancy can also trigger it.

Some types of warts caused by human papillomavirus (HPV) can also appear on shoulders.

While they’re generally harmless, if they grow too quickly or touch nerves they can become painful and may spread via direct skin contact or items touching an infected area like towels, razors, etc.

These warts tend to prefer moist environments like skin that has recently been injured – more likely inflicting soft or damaged surfaces first.

If you notice a lump on your shoulder, it’s wise to seek medical advice.

A physical exam and diagnostic tools such as ultrasound or MRI scanning may help identify what’s causing your discomfort.