An Armpit Lump in need of a cause

Two very annoyed and anxious faces appeared in my exam room on a Thursday afternoon. Mother and daughter pressed me to order an ultrasound for a large lump in Lynn's armpit.

A dermatologist had found the armpit (axilla) lump during treatment for acne. The dermatologist said it looked like an enlarged lymph node and noted Lynn's pediatrician could order a scan.

Lynn reported that the lump, with no signs of infection, had been there on and off for the past six months. At about the same time, Lynn remembered, her right shoulder had started hurting. Sometimes her shoulder pain would shoot to her elbow. Lynn shared that she carried a heavy backpack--slung over that right shoulder.

My exam confirmed that her shoulder was very restricted in movement and the lymph node was both enlarged and a little tender.

Within 20 minutes of FCS evaluation and treatment, Lynn walked out with no shoulder restriction, a nearly-normal size lymph node, and no pain. (We did not order an ultrasound, and Lynn now carries a lighter backpack on both shoulders.)