Contusion

Contusion, commonly known as a bruise, is a region of injured tissue where capillaries have been damaged by blunt trauma, leading to bleeding under the skin or tissues without an open wound. The resulting hematoma and inflammation produce tenderness, swelling, and ecchymosis that may change color as red blood cells break down.

Contusions can involve skin and subcutaneous tissue, muscles, or, less commonly, bone (bone contusion or bone bruise). They occur in sports, falls, vehicle accidents, and other blunt impacts. Deep contusions may be associated with muscle fiber damage and can limit strength or range of motion. Large contusions carry risk of myositis ossificans, especially in the thigh.

Diagnosis is usually clinical. If pain is severe, swelling extensive, or there is concern for fracture or a deep tissue injury, imaging such as ultrasound or MRI may be used; MRI can show bone marrow edema in bone contusions.

Treatment is typically conservative. Acute management follows RICE: rest, ice, compression, and elevation, followed by gradual return to activity as pain allows. Analgesics such as acetaminophen can be used; NSAIDs may be used cautiously. Avoid heat and massage in the first 48–72 hours. Rehabilitative therapy may help with stiffness and restore range of motion. Complications like compartment syndrome are rare but require urgent care.

Prognosis varies with depth and size of the contusion. Most heal in days to weeks; deep or large contusions take longer and have higher risk of complications. Prevention includes protective gear and proper conditioning in at-risk activities.