Lump on Elbow: Causes of an Elbow Lump or Mass

Where is the lump? Elbow lumps by location

Location narrows the cause quickly.

Common causes of a lump on the elbow

Olecranon bursitis (the "Popeye elbow")

A bursa is a thin, slippery sac that lets skin glide over bone. The bursa over the tip of the elbow (the olecranon) can fill with fluid and swell into a lump the size of a golf ball or bigger. This is elbow bursitis, and it is the classic soft mass on the elbow.

• Causes: leaning on the elbow for long periods (desk work, drivers, students, plumbers), a direct knock, gout or rheumatoid arthritis, or infection through a small cut.
• Feel: soft and squishy, often painless or only mildly sore. Bending the elbow is usually normal because the bursa sits outside the joint.
• Infected (septic) bursitis: the skin is red, hot and tender, and you may have a fever. About a third of cases are infected, usually with staph bacteria. This needs antibiotics and sometimes drainage.

Lipoma

A lipoma is a slow-growing lump of fat cells under the skin. It feels soft, doughy and rubbery, moves easily under your fingers, and is painless. Lipomas are very common, completely benign and can appear anywhere on the arm. They only need removal if they bother you or grow large.

Epidermoid cyst

An epidermoid cyst is a skin-level sac filled with keratin (a cheesy material). It is firm, round, attached to the skin and often has a small dark pore in the center. Cysts can become inflamed, red and sore, then settle. Do not squeeze them.

Gout tophi

In long-standing gout, uric acid crystals collect in chalky deposits called tophi. The elbow tip is a favorite site. Tophi feel firm or gritty, may look yellow-white under the skin, and can trigger sudden, very painful flares of bursitis.

Rheumatoid nodules

People with rheumatoid arthritis can develop firm, rubbery, usually painless rheumatoid nodules on pressure points, especially along the back of the forearm just below the elbow. They often appear in people with more active disease and may come and go.

Ganglion cyst

A ganglion cyst is a jelly-filled sac that grows from a joint or tendon sheath. It is far more common at the wrist but can occur around the elbow. Ganglions feel smooth and firm and may change size over weeks.

Swollen lymph node on the inner arm near the elbow

There is a lymph node called the epitrochlear node on the inner side of the arm, about 3 to 5 cm (1 to 2 in) above the elbow crease. It is normally too small to feel. It swells when it reacts to an infection in the hand or forearm, such as an infected cut, cat scratch disease or a nail infection. It feels like a small, tender bean that moves under the skin. A node that is large, hard, painless and lasts more than a few weeks, or comes with swollen lymph nodes elsewhere, needs blood tests and sometimes a biopsy to rule out lymphoma or other conditions.

Injury and bone causes

A hard lump after a fall can be swelling over a fracture, a blood collection (hematoma), or a bony spur. Long-term elbow arthritis can produce bony bumps at the joint margins. Rarely, a bone tumor causes a hard swelling with deep pain at night.

Rare: soft-tissue tumors

Most lumps are not cancer. A soft-tissue sarcoma is rare, but doctors watch for these features: larger than 5 cm (2 in), growing, deep (under the muscle covering), hard, fixed, or coming back after removal. Any of these warrant an ultrasound or MRI.

Soft vs hard lump on the elbow

How doctors diagnose an elbow lump

A doctor will ask when it appeared, whether it has changed size, whether you lean on your elbows, about gout, rheumatoid arthritis, recent cuts or scratches, and fever. They will feel the lump, move the elbow, and check for lymph nodes and other lumps.

Tests depend on the findings:

• Ultrasound: confirms whether the lump is fluid (bursitis, cyst) or solid (lipoma, node, tumor).
• Fluid aspiration: a needle drains fluid from a swollen bursa. The fluid is tested for bacteria and crystals to separate infection from gout.
• X-ray: shows bone spurs, fractures or calcified gout deposits.
• Blood tests: uric acid, inflammation markers, a blood count, or rheumatoid factor.
• MRI and biopsy: for lumps that are deep, hard, large or growing.

Treatment for a lump on the elbow

Non-infected bursitis

• Stop leaning on the elbow. Use an elbow pad or a folded towel on hard surfaces.
• A cold pack wrapped in a cloth for 15 to 20 minutes a few times a day can ease soreness.
• An over-the-counter anti-inflammatory such as ibuprofen can help, following the label dose, if you have no stomach, kidney or bleeding problems.
• A light compression sleeve may help the fluid settle.

Most non-infected bursitis settles over 3 to 6 weeks. A doctor may drain a large or persistent bursa. Steroid injections are used sparingly because they can cause infection and skin thinning.

Infected bursitis

Antibiotics by mouth, or through a drip if severe. The bursa may be drained with a needle, sometimes repeatedly. Surgery to remove the bursa (bursectomy) is reserved for infections that do not clear or bursitis that keeps coming back.

Other lumps

• Lipomas and cysts: left alone if small and painless, or removed in a short procedure under local anesthetic. Inflamed cysts may need draining first.
• Gout tophi: long-term urate-lowering treatment shrinks tophi over months to years.
• Rheumatoid nodules: usually managed by controlling the arthritis. They are removed only if they ulcerate or get in the way.
• Swollen lymph node: treating the infection usually shrinks it within 2 to 4 weeks.
• Suspected tumor: referral to a sarcoma or orthopedic specialist for imaging and biopsy before any removal.

Preventing elbow bursitis

Avoid resting on your elbows for long periods, use padding for kneeling-type work that loads the elbows (such as crawling under sinks or cars), clean and cover cuts on the elbow promptly, and keep gout well controlled.

Frequently asked questions

What is a soft lump on the elbow?

A soft, squishy lump on the point of the elbow is most often olecranon bursitis, a fluid-filled sac that swells after pressure, a knock or inflammation. A soft, doughy lump elsewhere around the elbow is usually a lipoma. Both are benign. Redness, heat or fever suggest infection and need same-day care.

What causes swelling on the inside of the arm near the elbow?

A small lump on the inner arm just above the elbow is often a swollen epitrochlear lymph node reacting to an infection in the hand or forearm. It can also be a lipoma, a cyst or medial elbow tendon inflammation. A node that persists beyond 3 weeks, or is hard and painless, should be checked.

Will an elbow bursa go away on its own?

Often, yes. A non-infected olecranon bursitis usually shrinks over 3 to 6 weeks if you stop leaning on the elbow and protect it. Larger or persistent swellings can be drained. Infected bursitis needs antibiotics and will not reliably settle on its own.

Should I pop or drain a lump on my elbow?

No. Draining a bursa or cyst at home risks introducing bacteria into the sac and causing a serious infection. If the lump is large, painful or keeps coming back, a doctor can drain it with a sterile needle and test the fluid.

Can an elbow lump be cancer?

Rarely. Most elbow lumps are bursitis, lipomas, cysts or nodules. Warning signs for a sarcoma or other tumor include a lump larger than 5 cm (2 in), one that keeps growing, feels hard and fixed, sits deep under the muscle, or returns after removal. These need imaging.

Why do I have a hard lump on my elbow?

Hard elbow lumps include gout tophi, rheumatoid nodules, bone spurs from arthritis, a healing fracture or a firm cyst. If you also have joint pain in several joints, ask about gout and rheumatoid arthritis. A hard lump that grows without a clear cause should be imaged.