Various localizations on bones and joints
Bone contusion can occur in all bones and joints and can cause different symptoms or pain depending on the location. A bruise on the knee can be caused both by an acute injury and by chronic strain. The former include in particular bumping the knee against a hard object, e.g.
the edge of a table, as well as sports injuries in the area of the knee, e.g. torn cruciate ligaments or meniscus injuries. A chronic bony contusion of the knee is usually caused by a malposition of a joint or inappropriate load (e.g.B. due to incorrect movement sequences or inadequately increased training).
Osteochondrosis dissecans is an important differential diagnosis to bone contusion of the knee. For reasons that are not yet fully understood (although similar reasons to chronic bone contusion seem to be relevant here), this leads to a circulatory disorder in the area of the bone below the joint surfaces and, as a result, to similar symptoms to chronic bone contusion. If a bone contusion of the knee is suspected, the physical examination and, if necessary, an x-ray examination are the main focus of the diagnosis.
If the complaints persist for a longer period of time after sparing the knee, an MRI examination can be carried out with regard to possible osteochondrosis dissecans or accompanying joint injuries. More on this topic: Osteochondrosis dissecans in the kneeA tibia contusion is very common, for example, when the tibia is bumped violently against an object. Shin bruises also occur more frequently in contact or speed sports.
At the shin, bruises can be very painful because there is almost no protective soft tissue layer over the bone to protect the bone from violent impact. In the case of large force effects, fractures of the tibia must also be taken into consideration. A bruise of the bone in the area of the foot can occur if, e.g. in soccer, an opponent steps on the patient’s foot.
If the pain is severe, an X-ray examination can rule out a possible metatarsal fracture. Another common injury mechanism that can lead to a bruise on the foot is kicks during certain martial arts such as kickboxing or taekwondo. Such a bruise on the foot also manifests itself as acute pain, which increases especially under stress or pressure.
In addition, swelling and possibly bruising often occur at the site of the injury. Besides the metatarsus, the ankle is the part of the foot most frequently affected by a bone contusion. Shoulder injuries, usually caused by falls, can lead to ligament, tendon and muscle injuries as well as bone contusions.
This causes swelling and pain in the shoulder area, which can also exist at rest and become more severe under stress. The most common injury mechanism is a dislocation of the shoulder joint due to the fall on the extended arm. The dislocation of the joint and the resulting rupture of muscle tendons and ligaments causes a violent impact on the bone, which results in the microfractures described above.
In this case, however, the therapy of shoulder dislocation focuses on the restoration of the tendon, muscle and ligament structures, so that the bone contusion does not receive specific treatment. Less severe cases, in which the structures mentioned are only overstretched or torn, can be treated conservatively by sparing them with a sling. More severe cases require surgical treatment.
In both cases, however, sparing, which should give the ligament and tendon structures the opportunity to heal, is also the optimal therapy for “incidental” bone contusions.
- Contusion of the shoulder
- Therapy of shoulder dislocation
Bruises on the elbow (olecranon) are often very unpleasant, since various nerves run along exposed and cause correspondingly strong pain when violently applied. Slight bruises on the elbow are often colloquially referred to as “bumping of the musician’s bone”.
This is an irritation of the ulnar nerve in its sensitive innervation area (nerve supply area) near the epicondylus medialis (inner side of the elbow). On the hand, a bony contusion can occur, especially in the area of the metacarpus and the wrist. The former area is affected e.g. during boxing, while a wrist contusion occurs mainly during falls that are attempted to be cushioned with the hands.
A finger can also be affected. A bruise of the hand also causes pain at rest and in movement, and possibly swelling. An X-ray examination can rule out a fracture as the cause of the pain.
Since the hand and wrist are also subjected to virtually constant stress in everyday life, it is particularly difficult to maintain a relieving posture for a sufficiently long period of time in this area in the event of a bone contusion. This is why very protracted processes often occur here.
- Bruise of the finger
- Pain in the wrist
In the area of the thigh, a bone contusion is rather rare due to the strong protective muscle mantle. This means that the relatively thick thigh muscles surrounding the thigh bone cushion much of the force that is transferred to the leg when the leg hits a hard object.
However, if there is a suspicion of a bruise on the thigh, an X-ray examination can rule out a possible bone fracture. The inner and outer ankle are parts of the upper ankle joint. The ankle joint itself has a strong tendency to bruise due to its high load and its weak muscular sheathing.
Therefore, either both ankles or only the inner or outer ankle can be affected by the bruise. A bone contusion in the ankle joint is usually the result of fouls in so-called contact sports, such as soccer or basketball. In addition to severe pain during exertion, but also at rest, swelling and redness of the ankle joint are the most common symptoms.
A special feature of the ankle joint, which it has in common with the wrist in particular, is its heavy everyday use. Patients with bruising of the ankle joint, especially at the beginning of therapy, usually complain of pain with practically every step or while standing, if not of pain at rest (i.e. while sitting or lying down). Since a bony contusion in the ankle joint is often accompanied by ligament injuries in the ankle joint, especially with tears of the outer or inner ligaments or syndesmosis.
For this reason, consultation with a specialist is necessary in cases of severe pain and swelling. Based on a functional examination of the ankle, a specialist can decide whether there is a suspicion of accompanying ligament injuries. In this case an MRI examination should be performed to confirm or rule out the suspicion.
If such injuries are detected during this examination, the therapy becomes correspondingly more complicated. A contusion of the zygomatic arch occurs regularly during contact sports such as handball or soccer. Physical confrontations can also lead to bruising of the zygomatic bone.
Affected persons show swelling, redness and bruising in the face below the eye at the level of the boiling of the cheeks. Bruises are treated conservatively here. If sensitive disorders or fracture clefts appear, a doctor should be consulted.
