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Dr. Tharun
Dr. Tharun, Doctor
Category: Health
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Experience:  MBBS
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I have a swelling under my left ribcage and pain which spreads

Resolved Question:

I have a swelling under my left ribcage and pain which spreads round to my back, an x ray and ultrasound have found nothing abnormal. they now want to do a bone scan but i have to wait 3 months. what could this be.
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Tharun replied 5 years ago.
Hello,

How long has bee the swelling there?

Is there any pain at the swelling?

Has it increased in size since its appearance ?

Is there any urinary complaints like blood in the urine?

Any breathing trouble?

Does it increase in size during straining or coughing?

Any blood thinners you are on?

Any abdominal complaints like alteration in bowel habits like constipation?

Does it pain after food?

Please let me know.

Regards,

Dr.Tharun
Customer: replied 5 years ago.

I have had it since November,

There is pain right inside the middle of my body, not on the swelling itself, the swelling seems to be fluidy.

The pain is a dull ache but sometimes gous around my ribcage to my back.

the swelling is just under my left breast and on my ribs.

It doesnt seem to have grown very much since I first noticed it.

I have no urinary complaints.

I have no pain when I breathe and no problems breathing.

I have IBS and suffer constipation but this doesnt seem to effect the pain.

I have no pain after food.

I have not had constipation this week and the pain is still there

It does not increase in size when I cough

The pain is not where the swelling is, it seems to be further inside my body.

I am not on any medication.

many thanks

Expert:  Dr. Tharun replied 5 years ago.
Hello,

Thank you for the answers.

From the answers it seems like a superficial swelling with dull aching pain and on the rib cage.My fist diagnosis would be hematoma that is collection of blood in restricted space.The hematoma is usually fluid in consistency with slight pain and remains constant in size.It could have been due to some trivial trauma or some times spontaneously due to coughing or straining or due to drugs(blood thinners).

Next diagnosis would be soft lipoma and it fits into description, but there is rarely any pain in lipoma.It is harmless condition and can be observed if it is not causing any problems.


The fact that there is no breathing problems and it doesn't increase in size on coughing reduces its chances of arising from the lungs.

If it was little lower on the abdomen then kidney swelling could be a possibility.

Another rare possibility is a tumor of the chest muscles(myosarcoma) which can present with features like this.

The best imaging technique of it is arising from the soft tissues would be an MRI scan.
Even if it is arising from the bone MRI can delineate it.

Also once it is confirmed there are no blood vessels in the swelling a needle biopsy or aspiration can be done which will reveal the contents of the swelling.

I hope this helps you.

Regards,

Dr.Tharun
Dr. Tharun, Doctor
Category: Health
Satisfied Customers: 3540
Experience: MBBS
Dr. Tharun and 5 other Health Specialists are ready to help you
Customer: replied 5 years ago.
Thank you. If it is a hematoma how is this treated and is it serious, if it is a tumor should I really wait the 3 months for a bone scan?? The waiting here in the UK is long and my husband died of cancer because they did not investigate quickly enough. Wouldnt the ultrasound scan have picked up a tumor?
Expert:  Dr. Tharun replied 5 years ago.
Hello,

Your concerns are valid.If it is hematoma then it is not a serious problem.It needs nothing but aspiration by a needle.If it is not coming then a small nick has to be made to drain the hematoma.

If it is tumor then 3 months waiting is not advisable.But tumors are hard to feel and grows in size (very important)and if it is so big in size from under the chest extending to the back it would have definitely caused other symptoms like bony back pain and weight loss and loss of appetite(new onset).

Ultrasound is not a very good imaging modality for soft tissue swelling and is operated Dependant.

I hope this helps you take a wise decision.

Regards,

Dr.Tharun

Customer: replied 5 years ago.
Thank you very much. I will go back to my doctor. You have been most helpful.

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