Hump behind the shoulders

Definition

Hump behind the shoulders is a lump of fat on the back of the neck.

Alternative Names

Buffalo hump; Dorsocervical fat pad

Considerations

A hump behind the shoulders by itself is not a sign of any one, specific condition. The doctor must consider this along with other symptoms and test results.

Causes

• Certain drugs used to treat AIDS
• Extended use of certain steroid medicines, including prednisone, cortisone, and hydrocortisone
• Extreme obesity
• Hypercortisolism (caused by Cushing syndrome)

Osteoporosis may cause a curvature of the spine in the neck called kyphoscoliosis. This causes an abnormal shape but does not by itself cause excessive fat in the back of the neck.

Home Care

If the hump is caused by a certain medicine, your doctor may tell you to stop taking the drug or change your dosage. Never stop taking any medicine without first talking to your doctor.

Diet and exercise can help you to lose weight and may relieve some humps due to extreme obesity.

When to Contact a Medical Professional

Make an appointment with your doctor if you have an unexplained hump behind the shoulders.

What to Expect at Your Office Visit

Your doctor will perform a physical examination and ask questions about your medical history and symptoms. Questions may include:

• What medications do you take?
• How old are you?
• Have you been checked for osteoporosis?
• What other symptoms do you have?

Diagnostic tests that may be performed include:

• Bone mineral density test
• Complete blood count
• Cortisol - blood
• Cortisol - urine
• CT or MRI scan of the head
• CT of the abdomen and adrenal glands
• Dexamethasone suppression test
• X-rays of the chest
• Visual field exam

Treatment will be aimed at the problem that caused the fat to develop in the first place.

References

Nieman LK. Adrenal cortex. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 245.

Stewart PM. The adrenal cortex. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, PA: Saunders Elsevier; 2008:chap 14.

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