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Is It Ok To Have A Hard Painless Bump On My Collar Bone?

Posted on Sat, 5 May 2012

Question: I was diagnosed with Rheumatoid Arthritis 4 years ago after my first pregnancy. I am 42 years old. Since then I had a second child and finishing breastfeeding for six months I started enbrel to treat my RA. I have done beautifully on enbrel and very happy.. Just discovered week ago a small bump on my right collar bone near my neck and throat. It is very hard and does not hurt. I noticed in the mirror. I just saw my Rheumtogist last week for my 3 month checkup and blood work. Blood work was normal. So I am just concerned because I do let anything get by me especially now that I have RA. Very worried.

Answered by Dr. Kiran Kumar (17 minutes later)

Hi,

Thanks for your query.

You mentioned that you have Rheumatoid Arthritis and are on Enbrel (Etanercept).
About a week ago, you have noticed a small, hard and painless swelling over your right collar bone.

Your routine blood tests were normal.

Your description suggests that the swelling is of bony origin. It mus be arising from the clavicle bone. Such swellings can be of multiple cause.
It can be due to
1. Rheumatoid Nodule - Although not a typical Site
2. Bony Cyst
3. Arthiritis of the Sternoclavicular Joint - This is usually painful.

Since your evaluation and labs are normal, i would reassure your as of now.
Such swellings can sometimes persist for few days to weeks before subsiding.
Enbrel does not cause such symptoms

Incase, it increases in size or if it becomes painful, you will need to undergo a BIOPSY to find out the exact cause of the swelling.

It will be helpful for me to give an advice if you could send some picture of the swelling. You can write to YYYY@YYYY with Subject: ATTN: Dr Kiran Kumar.

Hope this answers your question.

Thanks and Regards

Dr Kiran

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Kiran Kumar (51 minutes later)

Dr XXXXXXX

Thank You so much. Should I now follow up with my Rheumatologist or go see an Orthopedic doctor? Also, I did start working with a personal trainer twice a week for two weeks with the OK from my Rheumatologist. My work outs are pretty intense and could that have anything to do with the bump on my right collar bone? We do stretching and excercises of my shoulders since that is where most of my RA acute pain can occur --- due to picking up or carrying two children everyday. I will send you of the bump today.

Sincerely,
Denise Grosshans
404-307-9293

Answered by Dr. Kiran Kumar (6 minutes later)

Hi,

Thanks for getting back to me.

You should consult your Rheumatologist. If he clears you from his side, you might need to consult a Orthopedics Doctor. In some occasions, if you visit orthopedic doctor first, he might refer you back to your Rheumatologist as you have underlying Rheumatoid Arthritis.

Well I am happy that you have been exercising well. Some times if the exercise is too strenuous, you can developed minor swellings over bone which are due to stress fractures. However, they tend to be painful and you mention that your swelling is painless. So its less likely to be related to your exercise routine.

Will await your picture. Also make sure to reply to my dash board. Only then, I would be able to access your picture.

Thanks and Regards,

Dr Kiran

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Kiran Kumar (5 hours later)

Dr. Kiran:
Thank You so much. I will start with my Rheumatologist first. That is also the easier appointment for me since I am a established patient. I tried to send you a picture with your reply email address and I keep getting mail can not be delivered. Not sure what to do. Would like for you to see the picture. Thank You again for all your medical information. I will try again.

Sincerely,
Denise Grosshans
YYYY@YYYY

Answered by Dr. Kiran Kumar (13 hours later)

Hi,

Thanks for appreciation.

You can send me the photos to YYYY@YYYY with subject:ATTN Dr Kiran Kumar.
Please confirm by writing here about sending the photos, so that I can reply you at the earliest.

Thanks and Warm Regards,

Dr Kiran

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kiran Kumar (1 hour later)

Dr. Kiran:

I would like to confirm that I send my pictures to following email address: YYYY@YYYY with subject: ATTN: Dr. XXXXXXX XXXXXXX

Thank You,
Denise Grosshans

Answered by Dr. Kiran Kumar (1 hour later)

Hi,

Thanks for the images.

The pictures are suggestive of Swelling involving the Rt Sternoclavicular Joint. If you look at my first answer, the third possibility was Rt Sternoclavicular Joint Arthritis. Usually it is painful.

Since its not painful, its unlikely to be infectious.
This could be related to Rheumatoid Pathology.

Do consult your Rheumatologist and take it from here

Thanks and Regards

Dr Kiran

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Kiran Kumar (1 hour later)

Dr. Kiran:

Thank You so much. Somewhat of a relief but I am calling my Rheumatologist to get the first available appointment in the morning. I do have the most pain in my shoulders due to everyday tasks such as kids, home and now a full exercise schedule. Other than that I do feel really good. I will follow up with you once I see my Rheumatologist hopefully in the next few days.

Take care,
Denise

Answered by Dr. Kiran Kumar (6 minutes later)

Sure XXXXXXX

Wish you good health.

Dr Kiran

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Kiran Kumar (4 hours later)

Dr. Kiran:

Now that I have RA and two children -- I am very aware of what is going on with my body especially since I am taking Enbrel. Enbrel has been very good for me. Not a fan of Remicade because I do like the fact that I have to sit in a chair every six to eight weeks. Funny thing about RA is that "things" creep up with out a moments notice. IE "Flare, soreness and now the "bump on my right collar bone." Just trying to stay in check at all times. Just makes more aware of everything which is great and a curse for me.
Thank You again for your help!!
Denise Grosshans

Answered by Dr. Kiran Kumar (3 hours later)

Hi XXXXXXX

I understand your situation.
Unfortunately, we haven't yet found any cure for RA till now. For that matter many rheumatologic disease do not have a cure.

Etanercept (Enbrel) is being used for only a few years now. Infact before that, patients used to have more problems as medication were suboptimal in controlling the symptoms.

And do not worry. Wit proper medicines and followup, you can lead a normal life.

Thanks

Dr Kiran

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Raju A.T