There is a hard lump in the middle of the two ribs and it hurts a little bit, which may be caused by sebaceous cysts, lipomas, osteomalacia, malignant tumors and other diseases. 1. Sebaceous cysts: Sebaceous cysts may be caused by the blockage of the sebaceous glands of hair follicles and the accumulation of sebum to form cysts. When the larger cysts compress the surrounding tissues, patients may have localized redness, swelling, pain and other symptoms, which may be manifested as hard lumps in the middle of two ribs and painful sensation. 2. Lipoma: Lipoma can appear in any fatty part of the body and is a common benign soft tissue tumor. Its etiology is not clear yet, and it may be caused by genetic, chronic inflammation, systemic lipid metabolism abnormality and other factors. When the local tumor is too large and compresses the surrounding blood vessels and nerves, it may cause pain, and the patient may have a hard lump in the middle of the two ribs with a little pain. 3. Bone hyperplasia: when there is bone hyperplasia between the two ribs, hard lumps in the middle of the two ribs and pain may also occur. 4. Malignant tumor: there is a possibility of malignant tumor or metastatic cancer when there is a hard lump between two ribs, and when it presses the surrounding tissues, pain and other symptoms can also appear. There are many reasons that cause hard lumps in the middle of two ribs with a little pain, so patients are suggested to go to regular hospitals to find out the causes of the disease. Once diagnosed, patients should actively cooperate with doctors to take corresponding treatment measures. In daily life, we need to keep the local skin clean and clean, avoid scratching the skin.