Changes in a Puncture Hematoma: From Injury to New Concerns
Summary: An injury caused by a tack remover resulted in a large internal bruise that has since left a hard lump in my leg. Recently, after bumping it, the lump shifted position and became smaller. Last year, while trying to clear out screw holes on my metal roof in a rushed manner, I improperly wielded a tack remover. The tool slipped, resulting in a painful stab just below my knee. I quickly removed it and descended from the roof, reassured to find the bleeding ceased almost instantly. After carefully cleaning and bandaging the wound, I went about my day. However, after about two hours of activity, I noticed that the bandage was feeling unusually tight. Upon inspection, I discovered that the wound had been bleeding internally, causing a sizeable hematoma which began to grow significantly. I sought help from an EMT, concerned it might lead to compartment syndrome, and was advised to head to the emergency room. An X-ray confirmed extensive internal bleeding, with the hematoma nearly reaching the size of my knee. Fortunately, the wound eventually healed, albeit leaving a hard, immobile lump that felt like bone. Some months later, I accidentally fell on that area. To my surprise, the lump appeared to be smaller than before. A couple of weeks later, two identical lumps emerged overnight on every distal joint of my fingers. Just two weeks after that, the same phenomenon occurred on all ten toes. X-rays of my hands showed no abnormalities, leading me to consider the possibility of reactive arthritis, for which I have an appointment scheduled with a rheumatologist in September. Each time I discuss my knee lump with different doctors, they examine it briefly before expressing mild concern. This morning, I accidentally hit my leg against a drawer. An hour later, I squatted down and experienced familiar pain, noticing that the lump had shifted again—it was now smaller and seemed to have moved closer to my kneecap, rather than being located an inch below as it used to be. I am filled with questions regarding this unusual development. What exactly is this lump? Could it consist of metal fragments my body has surrounded? Is there a possibility of having it surgically removed? Moreover, could this lump be linked to the recent appearances of similar lumps on my fingers and toes? How can I seek further assistance if my primary care physicians dismiss these concerns?
Answers (1)
7/11/2025, 1:10:51 PM
OpenHealth AI
It sounds like you've been through a challenging experience with your injury and the subsequent developments around the hematoma and new lumps. Let’s break down your concerns regarding the lump in your leg, its possible nature, and the recent occurrences of similar lumps on your fingers and toes.
Main Points:
- The lump in your leg is likely a residual hematoma or scar tissue from your injury.
- Shifts in the lump's size and position can occur and may indicate changes in the tissue or surrounding conditions.
- The new lumps on your fingers and toes might not be directly related to the leg lump but warrant evaluation.
Explanation:
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Hematoma and Scar Tissue: After an injury, your body often reacts by forming a hematoma (blood collection outside of blood vessels) that can later become scar tissue. This can feel hard and immobile. Over time, this tissue can change as your body heals, which might explain the size and position changes you noticed, especially after impact.
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Possible Metal Fragments: If there were metal fragments involved in the injury (from the tack remover), it's plausible for your body to surround them, creating a lump. However, this would typically require imaging studies to confirm.
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New Lumps: The emergence of lumps on your fingers and toes may not be related to the hematoma but could indicate another condition like a form of arthritis or other inflammatory response. Reactive arthritis, which your rheumatologist will explore, could be one possibility.
Next Steps:
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Symptom Monitoring: Keep track of the size and shape changes of the lump in your leg, along with any pain, swelling, or other symptoms in your fingers and toes.
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Document Your Observations: Create a chart or log detailing when each lump appeared, their sizes, and any related activities (like bumping into objects). This information can be valuable for your upcoming rheumatology appointment.
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Seek Clarification: If your primary care physicians dismiss your concerns, consider requesting a referral to a specialist like an orthopedic surgeon. They can assess whether surgical removal of the lump is appropriate and also investigate any potential metal fragments.
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Follow Up on Rheumatology Appointment: Prepare specific questions for your rheumatologist about the connection between your leg condition and the new lumps. Inquire about the diagnostic process for reactive arthritis and any potential treatment options.
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Impact Management: While waiting for appointments, manage any discomfort or swelling in the lump by applying ice or over-the-counter anti-inflammatory medications like ibuprofen, following dosing instructions.
Remember, it's crucial to advocate for your health. Don't hesitate to express any concerns you feel have been overlooked during your appointments. You're taking the right steps by seeking further assistance. Please let me know if you need more specific guidance or have further questions.
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