Lumps and Bumps in Kids: When to Worry  

February 25, 2022
Wakenda Tyler, MD, Columbia University orthopedic surgeon
Wakenda Tyler

Lumps and bumps can appear anywhere on a child’s body, and as parents know, they do. Most bumps are benign, but some are not.

When does a lump, bump, or other protrusion merit a trip to the doctor?

“The first thing to ask yourself is: Can I connect the lump to a specific instance?” says Wakenda K. Tyler, MD, chief of orthopedic oncology at Columbia University's Vagelos College of Physicians and Surgeons, noting children can get bumps any number of ways in an ordinary day.

If you can identify the accident or activity source, and there are no broken bones, you’re likely good to treat at home.

Tyler recalls a worried mom and her son, who had a bump on his shin for about five days. He was not having any pain, so no X-ray was necessary (to rule out a fracture). When asked about any falls, the child reported he had banged his shin on an open dresser drawer a day before his mom noticed the bump.

“We recommended waiting another week to see if the bump resolved,” says Tyler, “and indeed it did. If it had not resolved, the next step would be imaging.”

When not to worry   

  • Child feels no pain, or pain is decreasing over one to two weeks.  
  • The lump is less than 2 cm, about the size of a quarter, and has not gotten bigger.   
  • No bones are broken.   

What to do: Stay home. Ice and rest.  

When to worry  

  • The lump is more than 2 cm, about the size of a quarter, or has gotten bigger.   
  • Pain has not subsided after two weeks, with ice or rest.  
  • Pain is increasing. 
  • Child has a fever or has lost weight. 
  • Child is waking up at night from the pain.   
  • Child is limping or favoring one side for more than three days without improvement. 
  • Child is unusually irritable and/or avoiding activities and sports they love.  

What to do: Call your doctor.   

Generally, says Tyler, the worrisome symptoms could be a sign of a growing mass of some kind. More often than not, it is a benign tumor that does not require treatment. In rarer cases, lumps can be a sign of cancer. Every year in the United States more than 2,000 children are diagnosed with bone and soft tissue sarcomas. Growing masses may need tests to rule out cancer.   

Bottom Line  

Most lumps and bumps in kids are not a big deal. Pay attention to the warning signs. If you have concerns, it’s best to get checked by your pediatrician to be safe. 

References

Wakenda K. Tyler, MD, MPH, is chief of the Division of Orthopedic Oncology and vice chair of equity, diversity, and inclusion in the Department of Orthopedic Surgery at Columbia University Vagelos College of Physicians and Surgeons.