Bone Bruise – How dangerous is that?

Definition

Bone bruise is the English term for a bone contusion. This is an injury to the bone caused by a direct, blunt force and can be accompanied by severe load-dependent pain.

Causes

Bone bruises are generally caused by direct blunt force, such as those caused by falls, bumping into hard objects and edges or sports injuries. This bruise is called a contusion in bones, internal organs or superficial bruises. As a consequence, in the case of bone, small to medium-sized blood and lymph vessels in the bone marrow, under the skin and especially between bone tissue and periosteum (periosteum) tear.

This causes oedema (accumulation of water in the intercellular spaces) and bruising (haematomas), which painfully stretch and irritate the periosteum. This is one of the most sensitive tissues of the body and is responsible for pain in all direct injuries in the bone area. Athletes in particular are often affected by bone bruise.

However, bone bruises also occur more frequently with increasing age, due to a weakly developed musculature, which protects the skeleton in healthy people from injury and ensures sufficient coordination to prevent falls. A bone bruise can be accompanied by bone marrow edema. The bone marrow is located within most bones and is mainly used for blood production.

It is very well supplied with blood and therefore susceptible to bleeding. It is usually well protected by the bone surrounding it on all sides. However, in the case of a more severe contusion, small microcracks in the vessels can lead to an effusion.

This accumulation can damage the bone, which is poorly supplied with blood and nourished, and can lead to long-term complications such as bone resorption and fatigue fractures. The effusion can only be detected in an MRI scan. The treatment options for bone marrow edema are also limited.

As a rule, only waiting will help. Unfortunately, the complete resorption of the bone marrow edema can take several months under certain circumstances. Until then, the affected body part must be relieved.

Symptoms

The first symptom of a bone bruise is a severe pain that starts immediately after the injury, but lasts only for a short time, usually a few minutes. Later on, persistent, stabbing pain appears, which becomes more severe especially under stress and when applying pressure to the affected area. The very sensitive periosteum is primarily responsible for this pain, under which bruises (haematomas) often develop in the case of a bone contusion, which stretch and irritate the periosteum.

Superficial bruises are also frequently seen at the affected area as a result of the injury. The area can also be very swollen. Bleeding and oedemas in the bone marrow can damage bone tissue over the next few weeks, resulting in the development of temporary osteoporosis. This promotes fractures in the area of the spinal column.