Lump on Rib

[Head2Toe]

Rib pain was one of my first and most significant symptoms that started in May 2013.  Initially it was on both sides, lower front ribs.  I distinctly remember my doctor poking at one of my ribs and when I withdrew in pain, he acknowledged it was 'tender'.  No x-rays were taken for that, but I did have two sets of chest x-rays in August 2013 when I developed pneumonia - and there was no mention of anything wrong with my ribs.  I finally saw an Internal Med Specialist said in November 2013 - but I was feeling considerably better by then and his diagnosis was that I had likely picked up some 'bug' while we were in Hawaii in May...  I believed that until symptoms flared again a few months later.

I told my 'old' Rheumy about this symptom in October 2014, but I don't remember him exploring it during the physical exam.

The lack of an official diagnosis and/or fuss based on chest x-rays left me believing that it's likely Costochondritis, and that like everything else going on in my body - it appears to be chronic.

The level of rib pain waxes and wanes, but it has never gone away and in fact it has spread - more ribs hurt, and they hurt around the sides in addition to the front.  Over the past several weeks when touching two specific painful places that are difficult for me to reach (closer to my back than front) I have caught myself wondering if those tender spots on my ribs are somehow 'bigger' than they should be    This is something I DEFINITELY intend to take up with my new Rheumy.

Last night I touched a tender spot on my lower left rib (that's been there since May 2013) and was shocked to find what was clearly a lump.  It's not soft tissue swelling - it's hard, immovable, irregular and maybe 2 inches long X 1 inch wide.  To ensure I wasn't imagining it, I asked my husband to confirm there was a lump there, which he did.   I have no idea how long that lump has been there 

So here I sit with a lump - and I have no idea what I should do.  Should I go to a walk in clinic today, or since this spot has caused pain for well over a year, should I just wait and discuss it with my new Rheumy at the end of March?

Does anyone know what Costochondritis inflammation feels like?  Does it cause a hard lump - or does it cause soft tissue around the rib to swell?

[Puzzled]

I think I would see another doctor about that lump and make sure it is addressed as to what the cause is.  However, that is just me. 

I have Costochondritis and I don't have lumps.  Since different people react differently to things I'm never really sure how something will affect one person vs another.   

I think I would try to get into a doctor sooner.  Do you have a GP?  A good one should be able to set you up with whatever testing you might need or get you into what doctor she/he feels might be best for you.  A lump would make me worry and at least you could take the stress away by getting some answers.

Now, that is just me and I tend to be overly cautious.  I have had some doctors make some major mistakes and I knew I didn't trust the doctor, but since I didn't want to question the doctor I went along with him.  I know now to not go with someone I don't trust and who just tries to ignore my concerns.  Again, that is just me and I'm sure you will get better info from those on the board with tons of knowledge.

I hope things work out for you soon.

[warmwaters]

Given you've got a lump, I'd go ahead and get it checked out. I did a quick read on the Mayo site, and the Costochondritis term is really just a descriptive term for the rib pain - the underlying cause can be from different things. So I would move on a lump - it could be some kind of tumor, and well worth getting looked at.

We're so used to dealing health problems that sometimes we say "oh, I'll deal with that later". But might want to make sure this isn't something too interesting.

[cccourt1942]

WarmWaters is right about root of costochondritis:  Inflammation.  Four little syllables that cannot describe the pain. Yes, I get it.  It is why I keep 5mg. tabs of prednisone at all times. 

The good news costochondritis subsides.  THAT fact is what worries me here.  I believe how the others have directed you.  I had this condition for 3 or 4 years before my SjS dx.  Didn't know what it was until 6 or more months AFTER my dx.  I had no idea "it" was something...nor did I know it went with SjS.  At this point if I drowned I would say it was due to SjS.  (kidding!)  SO many concomitant conditions!  Oh my.

The one calm thing I can say about your situation, I am reading the pain is there, but it never has gotten worse?  The chief complaint is the lump?  (which you don't feel pain from?  Right??) 

Costochondritis feels as if you have overexercised DRAMATICALLY...unless it hits you in the center of your chest.  Then it feels like a horse kicked you RIGHT there near/ at the base of your sternum.  MUCH pain.  You will benefit from searching for movements and activities which can bring this inflammation on.  When I cook...stand at the stove..lift lots of heavy pots and pans...I can have an attack.  I almost always have an attack when traveling as I am lifting a suitcase.  You carry it, you lift it , you lift it and place it on top of something, etc, etc.  I have had an attack carrying groceries into the house.  That was caused by my trying to carry too much in at one time.  Now I carry one or two bags at a time and make numerous trips.   I haven't been anywhere since last November.  I am taking a trip in March.  I WILL be good..but my prednisone will be packed with me.   You will be able to identify your triggers.  It hurts so badly you will not mind changing your routine when you figure out what brought it on. 

When I first started having the left side pains, I added twisting exercises on my pilates reformer.  When the pain would subside, I mistakenly thought I was building up strength.  HA HA!!  How the inflammation faded without medication and WITH my brilliant exercise solution, HA HA...I don't know how it ever went away. 

Here's the good news:  Since my last trip...followed by cooking at Christmas...I have not had an attack.  I have tried to think before I do anything.  I buy heavy items at the store one at a time.  I pull things along my floor instead of lifting.  Not an attack since I made myself fully aware I was causing the attacks. 

Good luck in finding how you are bringing these attacks on.  You will be thankful you figured it out.

And  the doctor says "Inflammation".  Really? One word?

c3

[Head2Toe]

Many thanks to everyone for your words of wisdom.

You know - if I had found this lump a year or more ago, I would have run red lights getting to an ER, but I've had so many symptoms discounted over the past couple of years that I hardly know how to respond to health issues any more.  I'm afraid to seek any medical attention without some sort of irrefutable evidence that I have cause for concern (e.g. coughing up blood would prompt action on my part).  I know the lump is abnormal and I will get it checked sooner rather than later. 

I discovered another lump about a year ago - it's on my knee.  It can clearly be seen with the naked eye, but I've never pointed it out to a doctor because it doesn't hurt or impact my mobility in any manner - and I want to MINIMIZE the things I'm complaining to my doctor about.  I assume it is a bone spur, but I do plan to point that one out to the new Rheumy.

The lump on my rib is very painful to the touch and it was painful in that spot long before there was a lump.  I cup my hand over that spot many times a day (perhaps as a form of self-nurturing?), but it's definitely not the kind of pain that would invite any kind of rubbing.  I have come to see bras as a form of necessary torture and wear one as seldom as possible.  In fact, about a year ago I started wearing a sports bra that's larger than my size to minimize the amount of pressure against my ribs, and even then I can't wait to get that thing off at the end of my work day.  If my husband drapes his arm around my ribs while cuddling in bed at night, I move his arm to my waist so it doesn't hurt. 

But as I stop and think about it, I don't think any specific movement makes it hurt unless that movement applies pressure.  I don't get much exercise these days, especially since the vertigo has set in, because I'm limited in what I can do.  I walk, and that's about it.

I haven't fallen into the habit of blaming everything on SJS, because I'm not even sure I have SJS.  I definitely suffer from dryness issues (eyes, mouth, throat, sinuses, lady parts) - but if anyone ever asked I would tell them that although the dryness sucks - it's the least of my issues.  Pain, tingling and numbness, tremors, feelings of muscle weakness, vertigo, balance issues (to name a few) are all much more of a concern than the dryness  

[cccourt1942]

OH YES!  The bras.  (*Hand goes up.*)
c3

[CaliSjogrenMale]

Any resolution to your rib pain and lump?  My first symptom was rib pain in my back that persists a whole year and a half later after I came down with these health issues.  I feel like my 11th or 10th rib in my back is swollen as I push on it I feel soreness and what might be the genesis of my right side abdominal dull ache and feeling of fullness.  Mention it every time at every Dr appointment I go to, primary, rheum, internist, GI etc no one can tell me anything about it.  When I'm feeling around back there it feels like the rib might be swollen and I believe I feel small moveable nodules smaller than pea size.  Hope this resolved for you and would appreciate an update as it haunts me daily!  Thanks!!

[irish]

Considering all the you have had and this lump I think it would be wise to see the doctor and demand (in a nice way of course) that a scan is done to rule out any other weird issue. The are some other diseases that show up on the ribs. There is one called Pagets disease that should be ruled out.

You might want to remember this disease in case the doctor drags his feet. You can mention this disease to let him know you have some knowledge and that putting the scan off isn't in the cards. Sometimes the docs like to make us think it is all in our heads. You probably are having some type of inflammation but the fact is, there are times when we just have to have some closure with an ongoing problem. Walking around with an "I don't know" can get old, can't it?? Good luck and keep us updated on how this is going. Irish