Diagnosis

In order to rule out more serious injuries to the bone, especially fractures, an X-ray of the affected body part should be taken first of all. However, a bone bruise selsbt is not visible in this x-ray. The characteristic microfractures and tissue swellings of the bone can only be detected by means of an MRI.

As a rule, however, the clinical symptoms in addition to an X-ray image are sufficient for diagnosis. In addition to the bone contusion itself, very similar symptoms can also be caused by other diseases. Apart from fractures of the bone, mainly tendosynovitis is to be mentioned here.

Especially in the area of the shinbone, these can make themselves felt by similarly strong, stabbing pain. In contrast to a bone contusion, however, they are not associated with trauma. In MRI, a bone bruise is characterised by a signal amplification.

A brightening of the affected bone can therefore be seen. The brightening is not caused by a fracture, but rather by increased water and blood retention in the area of the bone. It is assumed that the smallest microtraumas that trigger a Bone Bruise lead to an influx of fluid.

This is primarily water, but also inflammatory fluid, which flows in more strongly the more severe the trauma was in the shoulder area. In diagnostics, a danger often lies in the fact that a minimally hairline fracture in the shoulder area cannot be seen because it has been hidden by the lightening caused by the water. The fluid gradually decomposes again within a few weeks. In some cases, however, the water in the area of the shoulder bone can be detected for months. It is not known whether there are other causes than the microtraumas, which is why water retention occurs in a bone bruise.

Therapy

For the treatment of a bone bruise, the so-called “PECH rule” applies above all. In addition, the use of painkillers and anti-inflammatory drugs is recommended. These include ibuprofen and diclofenachal painkillers.

Paracetamol is less suitable here because it lacks the anti-inflammatory effect. Ointments and gels are mainly used to cool bone contusions. If large bruises form which are obviously poorly reabsorbed, i.e. persist for a long time, surgical opening of the haematoma can be considered to prevent infection.

Rest – immobilisation of the affected bone or joint, possibly with a support bandage and in the lower extremities with a splint and/or crutches if necessary; sport should be avoided for the next few weeks to months
Ice – Cooling the injury
Compression – in the form of a pressure and support bandage to prevent swelling and stop small bleedings
Elevation – also to minimize bleeding and swelling

The therapy of a bone bruise takes place for the most part in the first minutes after the injury. Here, among other immediate measures, the affected body part should be relieved in order to reduce a hematoma. Through immediate protection and cooling, an attempt is made to quickly stop the flow of buttocks so that no large amounts of blood can penetrate the soft tissue and the periosteum.

Externally, a reddening can also be seen in the first minutes after the injury. However, as soon as the blood starts to clot and no more blood comes out, there is no need to relieve the pressure. This is usually the case after about half an hour.

However, the duration also depends on the severity and exact location of the injury. Bleeding in the area of the abdomen or chest can last longer. If a bleeding is unstoppable, a doctor must be consulted urgently.

A Bone Bruise is normally not a major injury, which is associated with a restriction of movement. The main purpose of physiotherapy is to maintain or restore normal body movements. Also, the pain of a Bone Bruise is only high in the first few minutes of the injury and is then felt as a painful pressure at the site of the haemotoma. Physiotherapy is therefore rarely necessary and can hardly accelerate the healing process.