8 Y/O son with a lump on his chest/sternum..Please help..

[clue21]

Please let me apologize in advance if I seem to be rambling, Im just a concerened father over here. My 8Y/O son has been to the doctor recently because he complained about pain on his chest. The doctor noticed a little lump/bump with redness right on the sternum area. It was really painful for a day or so. The pain has subsided, and the redness gone away. However, it is still slightly painful to the touch. He has no fever, loss of appetite , etc. They performed Xrays, and blood tests, and ruled out a bone infection, and fracture. They think its probably just a sprain, strain or hematoma. Its been about 10 days, the lump is still there, it is not moveable. Might be getting smaller, unsure. It might just be wishful thinking by me, but it definitely isnt getting larger. The redness is gone too! Wheeww! My son is a very active kid, he indicated he might have been kicked in the chest by his sister. He is pretty rough. He also indicated about a month ago that his chest hurt a little, just thought it was growing pains though. Like I mentioned though, he plays hard!  My question is this; if there was an abnormal growth (tumor, cancer, etc) would the Xray and blood test have picked it up? And how long if it is a sprain do these dang lumps go away? Im just happy that the doctor said everything looked okay, but he has told us to come back if hes still in pain in a few weeks. What do you think this could be? Three questions, Im a worried father over here. I apologize for the long story doctor, but Im losing my mind over here. I want to take him to the doctor again, but I dont want them to think Im crazy.  Thank you, take care

[J.M. Keyes, MD]

Hi there,
I can understand your concern.  It sounds like the lump is starting to resolve, which is a good sign.  Physical exam is very important in a situation like this, so I am limited in how much I can help, and defer to your MD who has examined the lump and your son in general.  Based on your description, it does not sound like anything overly worrisome.

A CT of the chest is the best way to delineate a bony mass in the chest, and a CRP and ESR (blood tests) would give a good indication if there was any concern about infection or malignancy (your doctor may have included those in the initial bloodwork).
If your son is not feeling better within a month, I would return to your doctor, and discuss the possibility of further testing (taking into account their exam and opinion of course).
If things are changing or getting worse (increased pain, fevers, weight loss, night sweats etc) follow up sooner.

Best of luck,
JMK MD

[seattle253]

Thank you for your response. I just want to try to clear up one thing. Is the Chest Xray not a good tool in diagnosing a tumor and or cancer? On various websites they note the chest Xray as a good diagnosing tool for those such things. Although I am hearing different opinions. Also, just one last question..... Have you ever seen a hematoma or contusion without any noticeable discoloration? Just curious.. And how long can these masses stay swollen. I called a nurse helpline provided by employer and she indicated 2-4 weeks, sometimes longer! Is this true? Once again, I thank you for your help, take care!