Contusion; Hematoma
DefinitionA 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.
ConsiderationsThere are three types of bruises:
Bruises can last from days to months, with the bone bruise being the most severe and painful.
CausesBruises are often caused by falls, sports injuries, car accidents, or blows received by other people or objects.
If you take a blood thinner, like aspirin or warfarin (Coumadin), you are likely to bruise more easily.
SymptomsThe 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.
Do NotCall your doctor immediately if 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 vital blood and oxygen to the tissues. This is potentially life-threatening and you should receive emergency care promptly.
Also call your doctor if:
In the rare instance of "compartment syndrome," surgery frequently needs to be performed to relieve the extreme buildup of pressure.
PreventionBecause bruises are usually the direct result of an injury, the following are important safety recommendations:
Schafer Al. Approach to the patient with bleeding and thrombosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 178.
Buttaravoli P. Contusion: (Bruise). In: Buttaravoli P, ed. Minor Emergencies. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap 137.
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