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Dr Shayan Ahmed

Shoulder Lumps: Causes, symptoms and how an ultrasound can help with diagnosis

December 22, 2023, 22:12

Discovering a lump in your shoulder can be an unsettling experience, causing both physical discomfort and a wave of concern.

It's important to understand potential shoulder lump causes, recognise the accompanying symptoms, and explore the available diagnostic methods to gain clarity and peace of mind. This includes safe, non-invasive shoulder ultrasound scans

Types of Lumps in Shoulder

A lump in your shoulder could be caused by one of many conditions (1), each with its own distinctive characteristics. Learning about the various types of shoulder lumps is crucial in identifying the specific condition and determining the appropriate course of action for diagnosis and treatment.

Abscess

One cause of shoulder lumps is a skin abscess (2), which is a pus-filled lump deep under the skin. It is usually caused by a bacterial infection and can appear as a round, firm, and sometimes painful lump.

Abscesses may also exhibit redness, pus drainage, and warmth to the touch and can be accompanied by fever and chills.

Arthritis

Shoulder lumps can be related to arthritis, which is joint inflammation. Rheumatoid arthritis (RA) can cause rheumatoid nodules, which are flesh-coloured, hard or dough-like lumps that usually appear on bony areas like the shoulders.

Osteoarthritis (OA) can lead to bone spurs called osteophytes, which often occur around affected joints. Osteophytes on the shoulders, neck, knees, fingers, and feet may not always cause symptoms but can result in pain or limited joint motion if they press on nerves or tissues.

Cancer

While rare, a shoulder lump could indicate soft tissue sarcoma, a type of cancer that forms tumours in connective tissues like muscles, tendons, and nerves (3). Soft tissue sarcomas are typically painless but can cause pain and restricted movement as they progress.

Squamous cell carcinoma, a type of skin cancer, can also cause shoulder lumps in the form of rough, scaly patches resembling warts.

Cyst

Shoulder lumps can also be cysts, which are closed sacs of tissue containing pus, air, or fluid. Different types of cysts can develop on the shoulder and around the shoulder area, such as epidermoid cysts, paralabral cysts, ganglion cysts, and bone cysts.

Epidermoid cysts are painless coloured sacs filled with keratin, while paralabral cysts contain joint fluid and can sometimes cause pain if they press against nerves or tear surrounding cartilage.

Lipoma

A lipoma (4) is a benign fatty tissue lump that often appears on the neck, shoulder, and armpits. It is typically rubbery, soft, and doughy to the touch.

While lipomas are usually painless, they can cause discomfort if they press on blood vessels or nerves.

Injury

Shoulder lumps can form following a shoulder injury, such as a fracture, separation, or muscle contusion. Fractures occur when a shoulder bone breaks, resulting in pain and swelling. You may also develop a lump in the area the bone broke.

Separated shoulders occur when ligaments connecting the collarbone and shoulder blade rip apart, causing a lump on top of the shoulder. Muscle contusions, or injuries to the muscle fibres, can cause swelling, bluish discolouration, and the formation of a lump called a hematoma.

Knots

Muscle knots, also known as myofascial trigger points, can occur in any body part, including the neck and shoulder area. They are groups of tense muscle fibres that result from muscle tissue contracting even when at rest.

Symptoms of muscle knots include pain, sensitivity, and swelling. A lack of activity or too much use can cause muscle knots. In contrast, exercise and massages can help alleviate them.

Pimples or Warts

Shoulder lumps can also be large pimples or warts. Pimples occur when pores are full of dead skin cells and oil. Larger pimples, such as cystic acne and nodules, can be painful.

Warts — caused by a human papillomavirus (HPV) infection (5) — can occasionally appear on the shoulders, although they are more common on the hands. They can be small or large in size, bumpy or smooth, and may have various colours.

Diagnosing Shoulder Lumps

From physical examinations to advanced imaging techniques such as ultrasound, each diagnostic tool plays a crucial role in uncovering the underlying cause of the shoulder lump and guiding effective treatment decisions.

Physical Exam

A doctor will perform a physical exam, examining the lump by touch and looking for associated symptoms like redness and swelling. This evaluation helps determine the appropriate diagnostic approach.

MRI Scan

An MRI scan utilises radio waves to capture detailed images of soft tissues, providing valuable information for diagnosing shoulder lumps.

X-Ray

If a lump is suspected to be on the bone, an X-ray may be necessary to obtain images of the affected area and assess any bone-related abnormalities.

CT Scan

A CT scan involves taking X-rays from multiple angles to generate cross-sectional images, aiding in the diagnosis of shoulder lumps.

Biopsy

In cases where a lipoma or tumour is suspected, a doctor may recommend a biopsy. This procedure involves taking a sample of tissue from the lump and examining it in a laboratory to determine its nature.

Ultrasound

A shoulder ultrasound can play a crucial role in diagnosing various types of shoulder lumps. The quick, non-invasive, painless medical imaging technology uses sound waves to capture pictures of the inside workings of your shoulder.

It allows for the visualisation of the shoulder joint, assessment of pain and range of movement, and evaluation of tendons, muscles, and ligaments. Specialists can also identify signs of inflammation and fluid, assess abnormalities, and flag any causes of concern.

The ultrasound scan provides real-time imaging, enabling doctors to make accurate diagnoses based on the captured images.

What to Expect from Your Shoulder Ultrasound

A shoulder ultrasound typically lasts between 15 and 30 minutes. The doctor or specialist will apply a clear, water-based gel to the affected shoulder, easing the movement of the ultrasound probe over the skin without causing discomfort.

The probe will emit sound waves and capture images of the muscles, joints, and soft tissues in the shoulder region. These images will help the doctor identify the underlying cause of the shoulder lump and provide an accurate diagnosis.

After the ultrasound, no specific aftercare is required, though follow-up treatment may be necessary based on the diagnosis.

When to Seek Medical Assistance

If a shoulder lump persists for more than two weeks, grows in size, causes pain or discomfort, or does not move, visit a doctor for further evaluation.

Seeking immediate medical attention is crucial in cases where the shoulder lump is a result of a recent injury or if there are signs of a serious condition.

Schedule a Shoulder Ultrasound Today

Shoulder lumps can vary in size, texture, and pain levels. While most lumps are harmless, it is essential to seek medical advice for proper diagnosis and appropriate treatment.

Ultrasound is key in diagnosing lumps, providing detailed insights into the underlying shoulder lump causes. If you're experiencing shoulder lumps, schedule an ultrasound with our dedicated team of medical professionals to ensure a timely and accurate diagnosis. Book your appointment now.

Don't ignore persistent or concerning shoulder lumps; take proactive steps to address them and regain your shoulder's health and comfort.

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