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Bruise

Contusion; Hematoma

A 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.

Images

Bone bruise
Muscle bruise
Skin bruise

Presentation

Bruise healing - series

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Considerations

There are three types of bruises:

Bruises can last from days to months. A bone bruise is the most severe and painful.

Causes

Bruises are often caused by falls, sports injuries, car accidents, or blows received from other people or objects.

If you take a blood thinner, such as aspirin, warfarin (Coumadin, Jantoven), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), or clopidogrel (Plavix), you are likely to bruise more easily.

Symptoms

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.

First Aid

In the rare case of compartment syndrome, surgery is often done to relieve the extreme buildup of pressure. Compartment syndrome results from increased pressure on the soft tissues and structures beneath the skin. It can decrease the supply of blood and oxygen to the tissues.

Do Not

When to Contact a Medical Professional

Call your health care provider right away 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 compartment syndrome, and can be life-threatening. You should receive emergency care.

Also call your provider if:

Prevention

Because bruises are usually the direct result of an injury, the following are important safety recommendations:

References

Buttaravoli P, Leffler SM. Contusion (bruise). In: Buttaravoli P, Leffler SM, eds. Minor Emergencies. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 137.

Cameron P. Trauma. In: Cameron P, Jelinek G, Kelly A-M, Brown A, Little M, eds. Textbook of Adult Emergency Medicine. 4th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015:71-162.

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Review Date: 5/13/2019  

Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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