This shows a knot and you can also see his collar is either wet or bloody. It is very noticeable if you play with contrast. Also, if I am able there is one place where it looks like his jacket may be frayed, torn--back left side.
I'll try to do better later or in the morning. Or maybe somebody who is much better at this can do it?
Good post, thank you. That knot is something not being focused on.
As for the breaking his own nose stuff, what is this, Fight Club?