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    Bruise

    A bruise is an area of skin discoloration. A bruise occurs when small blood vessels break and leak their contents into the soft tissue beneath the skin.

    Contusion; Hematoma

    Considerations

    There are three types of bruises:

    • Subcutaneous -- beneath the skin
    • Intramuscular -- within the belly of the underlying muscle
    • Periosteal -- bone bruise

    Bruises can last from days to months, with the bone bruise being the most severe and painful.

    Causes

    Bruises are often caused by falls, sports injuries, car accidents, or blows receivedfromother people or objects.

    If you take a blood thinner,such asaspirin or warfarin (Coumadin), you are likely to bruise more easily.

    Symptoms

    The main symptoms are pain, swelling, and skin discoloration. The bruise begins as a pinkish red color that can be very tender to touch. It is often difficult to use the muscle that has been bruised. For example, a deep thigh bruise is painful when you walk or run.

    Eventually, the bruise changes to a bluish color, then greenish-yellow, and finally returns to the normal skin color as it heals.

    First Aid

    • Place ice on the bruise to help it heal faster and to reduce swelling.Wrap the ice in a clean towel--do notplace ice directly on the skin. Apply the ice for up to 15 minuteseach hour.
    • Keep the bruised area raised above the heart, if possible. This helps keep blood from pooling in the bruised tissue.
    • Try to rest the bruised body part by not overworking your muscles in that area.
    • If needed, take acetaminophen (Tylenol) to help reduce pain.

    In the rarecase of compartment syndrome, surgeryisoftendone to relieve the extreme buildup of pressure.

    DO NOT

    • Do nottry to drain the bruise with a needle.
    • Do notcontinue running, playing, or otherwise using the painful, bruised part of your body.
    • Do notignore the pain or swelling.

    When to Contact a Medical Professional

    Call your health care providerright awayif you feel extreme pressure in a bruised part of your body, especially if the area is large or very painful. This may be due to a condition known as compartment syndrome. Increased pressure on the soft tissues and structures beneath the skin can decrease the supply of blood and oxygen to the tissues. Thiscan belife-threatening and you should receive emergency care.

    Also call yourhealth care providerif:

    • You are bruising without any injury, fall, or other reason.
    • There are signs of infection around the bruised area including streaks of redness, pus or other drainage, or fever.

    Prevention

    Because bruises are usually the direct result of an injury, the following are important safety recommendations:

    • Teach children how to be safe.
    • Be mindful to avoid falls around the house. For example, be careful when climbing on ladders or other objects. Avoid standing or kneeling on counter tops.
    • Wear seat belts in motor vehicles.
    • Wear proper sports equipment to pad those areas most frequently bruised, such as thigh pads, hip guards, and elbow pads in football and hockey; shin guards and knee pads in soccer and basketball.

    References

    Piette WW. Purpura. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, Pa.: Elsevier Saunders; 2012:chap 22.

    Brinker MR, O’Connor DP, Almekinders LC, et al. Physiology of injury to musculoskeletal structures: 1. Muscle and tendon injury. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa.: Elsevier Saunders; 2009:chap 1, section A.

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    • Bone bruise

      illustration

    • Muscle bruise

      illustration

    • Skin bruise

      illustration

    • Bruise healing - series

      Presentation

      • Bone bruise

        illustration

      • Muscle bruise

        illustration

      • Skin bruise

        illustration

      • Bruise healing - series

        Presentation

      Self Care

        Tests for Bruise

          Review Date: 4/14/2013

          Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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