contusions

A contusion, commonly called a bruise, is an injury to soft tissue caused by blunt trauma that damages small blood vessels without breaking the skin. Blood leaks into the surrounding tissues, producing swelling, tenderness, and discolored skin as hemoglobin is broken down.

Contusions vary in depth and size. Superficial contusions involve skin and subcutaneous tissue with ecchymosis that changes color from red or purple to greenish-yellow over days. Deeper contusions affect muscle tissue and may form a hematoma, causing more swelling and stiffness. Most contusions heal within days to weeks, though larger injuries can take longer and may lead to stiffness or limited movement, particularly in people with bleeding disorders or on anticoagulants.

Diagnosis is usually clinical, based on history and physical examination. Imaging is reserved for suspected fractures or more extensive soft tissue injury. X-rays rule out bone injury; ultrasound or MRI may be used for deeper tissue assessment when needed.

Treatment focuses on reducing pain and swelling. The common approach is protection, rest, ice during the first 24 to 48 hours, compression, and elevation (RICE). Analgesia such as acetaminophen can relieve pain; NSAIDs may be used with caution, considering individual bleeding risk. After swelling subsides, gradual return to normal activity is encouraged.

Prognosis is generally favorable, with most contusions healing without complications. Persistent or recurrent contusions may prompt evaluation for underlying issues such as clotting disorders or medication effects. Prevention centers on protective equipment and safety measures to minimize blunt trauma.