bruised

Bruised, medically termed contused, describes an injury in which small blood vessels are damaged after blunt trauma, causing blood to leak into surrounding tissues without the skin necessarily breaking. The resulting collection of blood beneath the skin is called a contusion or ecchymosis.

Causes and mechanism: Bruises arise from a variety of impacts such as falls, sports, or blunt blows. Less common contributors include medical conditions that affect clotting (for example, platelet disorders or anticoagulant medications) or repeated minor trauma. The initial damage causes local bleeding, tissue fluid accumulation, and inflammation, which together produce pain and swelling.

Color changes and healing: A bruise typically changes color as blood cells break down. It may appear red or purple at first, then blue or dark as it pools, followed by green from biliverdin and yellow from bilirubin as the body reabsorbs the blood. Over days to weeks, the bruise fades as the blood is cleared and the tissue repairs itself. Healing time depends on bruise size, location, age, and overall health.

Clinical features and diagnosis: Bruises present as tender, sometimes swollen areas with visible discoloration. The skin remains intact. Seek medical evaluation if there is severe pain, numbness, deformity, swelling that worsens, or bruising in unusual locations or without known injury, as these may signal a fracture, deep tissue injury, or a bleeding disorder. Diagnosis is usually clinical; imaging is reserved for suspected fractures or complications, and tests may be used if recurrent or unexplained bruising occurs.

Treatment and prognosis: Management centers on protection, rest, ice in the first 24–48 hours, compression, and elevation. Pain can be managed with appropriate medications, mindful of bleeding risk. Most small bruises heal within a couple of weeks; larger contusions may take longer.

See also: contusion, ecchymosis, hematoma, bleeding disorders.