Lumps and bumps

Contributed by Dr Philip Marazzi, a GP in East Horsley, Surrey


This woman fell and sustained this injury to her forehead. She was not knocked out, and was otherwise well. She presented two weeks later complaining that she was 'not right'. Again no obvious cause was found, but she was referred to exclude a chronic subdural haematoma. In fact this was not found and she did eventually get back to normal.


This woman had developed this swelling on her inner thigh some years earlier. She thought that it was just her fat thigh. In fact it was a lipoma. Due to the size of the lipoma and the soreness and discomfort it was causing, she decided to have it removed surgically.

Olecranon bursitis

This man was amused by the cartoon-like swelling that developed on his elbow. It did not cause him any problems so no action was taken. Occasionally an anti-inflammatory may be used for bursitis if there is discomfort. Aspiration is temporarily effective, but the bursa often refills.


This 39-year-old woman presented with a rather large varicosity on her leg. She did not want anything done about it. She was advised to avoid any trauma as the risk of significant blood loss is quite high.

Heberden's nodes

This lady has widespread osteoarthritis. This characteristic appearance of the distal interphalangeal joint is commonly seen. Less often, the proximal interphalangeal joint is affected - an appearance known as Bouchard's nodes.

Inguinal hernia

This man has a large inguinal-scrotal hernia. It extended down into the scrotum and had been present for some time. Surgical correction is the option for most patients, though some prefer to accept the risk of strangulation and manage with a 'truss'. Surgery has become a much simpler and safer procedure since the change to laparoscopic techniques, with small scars, less pain, fewer complications, shorter hospital stays and low recurrence rates. This patient was not suitable however and required open reduction.

Hallux valgus

This woman was bothered by her inability to get comfortable shoes and requested surgical correction of the deformity. The deformity ran in her family. Appearance alone is not usually an adequate indication for surgery, unless accompanied by pain.

Clavicular swelling

This man had a history of a fractured clavicle in the past. It had healed satisfactorily at the time, but he presented with a new swelling. An X-ray merely showed a healed fracture and nothing more sinister. It was unclear what exactly caused the swelling but it appeared stable and no action was taken.

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