Hard palpable lump next to elbow. had ultrasound today 4.8cm wide, 1.38 cm deep. sonographer said it wasn't bursitis or lipoma?

Needs assesment: If it isn't the two common conditions listed above - and a good sonographer should be able to tell - then a solid lesion of that size should definitely be seen by a general or orthopedic surgeon and undergo a core needle biopsy prior to surgery. It could represent a sarcoma or other tumor. If you had previous injury to that area it may be a hematoma, but that can usually be diagnosed on us.

Large lump: I would see a surgeon at this point for further evaluation and consider an MRI or biopsy, if warranted.