Bone Contusion

A bone contusion (bone bruise) is a relatively common injury to a bone that is less severe than a bone fracture, resulting in injury to the bone on a microscopic level, without a discreet or visible fracture line on xray or advanced imaging such as MRI or CT scan. Bone contusions may occur in any bone, and may happen to people of all ages and activity level.

Bone contusions are a common sports injury. Bone contusions may occur as isolated injuries, or they may occur in conjunction with injuries to ligament, tendon, cartilage, or other structures. For instance, most anterior cruciate ligament (ACL) tears include acute bone contusions to the lateral femoral condyle and lateral tibial plateau at the time of the injury. Isolated bone contusions often result from direct impact, such as colliding with another player in contact sports such as football, soccer, basketball, or rugby.

Diagnosis of a bone contusion can often be made from clinical history and exam with reasonable certainty. Based on the preferences of the patient and circumstances of the injury (professional versus recreational athlete, in-season versus off-season, etc.), an individualized approach will determine whether advanced imaging is necessary.

Types of treatment

Treatment for a bone bruise may include:

  • Resting the bone or joint, including crutches to support your weight
  • Putting an ice pack on the area several times a day to decrease swelling and pain
  • Raising the injury above the level of your heart to reduce swelling
  • Taking medicine to reduce pain and swelling, most commonly a non-steroidal anti-inflammatory (NSAID)
  • Wearing a brace or other device to limit movement, if needed; often a pad is helpful when returning to sport, as the area is more sensitive to contact until fully healed

Possible complications of a bone bruise

Most bone bruises heal without any problems. Rarely bone bruisesare severe and very large, and a portion of the bone may die due to permanently compromised blood supply. This is referred to as avascular necrosis or osteonecrosis of the bone. Although rare, this comprises an important reason to seek evaluation by an orthopedic surgeon and follow-up until the injury is resolved, with return to sport only when deemed safe by the medical team including the physician, therapist, and trainer.

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