What Is Meant By A Bone Contusion?
What A Contusion Is - What is meant by a bone contusion? In very simple terms, it's a bone bruise. In medical terms, a contusion is a hematoma, a collection of blood in tissues in which capillaries and tissue fibers have been damaged. Anytime we have a bruise, we've suffered a contusion. A visible bruise is caused by damage to tissue lying underneath the skin, and the subsequent bleeding. A contusion is often defined as an injury to underlying tissues where the skin itself has not been broken.
What then has occurred when we've suffered a bone contusion? It would seem that our bones, being hard and rather solid, would be difficult if not impossible to bruise. The truth is, bones can bruise fairly easily. The reason we don't suffer from bone bruises more than we do is because our bones are for the most part well protected by muscles and other tissue.
The Cross-Section Of A Bone - To better understand how a bone can be bruised, a description of what the cross-section of a bone looks like might be helpful.
First of all, there is a layer of protective tissue, the periosteum, which covers the outside surface of the bone. This tissue, which might be described as a thin layer of whitish skin, which it in fact it is, is very rich in blood vessels and nerve endings. Underneath this protective layer of skin is what is called compact bone. Compact bone is very hard and very strong, consisting primarily of calcium and other minerals. Compact bone is not solid, even though it appears to be. Compact bone is honeycombed with small canals containing nerves and blood vessels which supply blood and oxygen to the inner part of the bone. Compact bone is not dead tissue as is the case with our hair and fingernails. Compact bone is living tissue.
Compact bone surrounds soft spongy tissue we call the bone marrow. The marrow itself has the consistency of gelatin. The soft, spongy tissue in which the marrow resides is rich in blood vessels and nerve endings.
A Muscle As An Example - Think of bone as being somewhat like a muscle, but whose fibers are very, very tightly-packed and solid, and you might get a better idea of what has happened when a bone suffers a contusion. When we strain a muscle, fibers in the muscle are damaged or broken, often only at a microscopic level, like what happens during hard exercise. When a bone is hit with blunt instrument, tiny fibers in the bone can be damaged, and even broken. If enough fibers are broken, the bone fractures. If not enough fibers are broken to fracture the bone, we have experienced a contusion. A bone contusion is an injury to the bone that does not cause the bone to fracture. A contusion can be fairly mild, or it can be severe enough such that it needs to be treated in the same way a fracture would be treated.
Bone Contusions Can Be Very Painful - The pain caused by a bone bruise can be quite severe at times, and also can be quite long-lasting. In some instances it takes longer to treat a bone bruise than it does to treat a simple fracture. The problem is often compounded if the injury to the bone occurs at the end of the bone, near a joint. When this is the case, it is not unusual that ligaments and cartilage are also damaged. When the joint is affected, recovery time can be even longer. It just so happens that most bone contusions do occur at or near joints, especially knee, wrist, elbow, ankle, and hip joints. One reason for this of course is that these are the areas where most injuries occur during athletic or sporting events.
Diagnosis And Treatment - A bone contusion will not show up in an x-ray, but a doctor may still take an x-ray to see if the bone has been broken. A contusion is therefore often diagnosed though a process of simple elimination. Before the advent of MRI scans, one had to assume that if there was a great deal of pain but no fracture, the bone was bruised. Such a diagnosis was usually correct. A MRI scan provides positive verification that a contusion has indeed occurred.
Treatment of bone bruises often involve a good deal of rest. Not only can movement be painful, but if a bone bruise is not given rest, damage to nerves can occur. Steroid injections are often used to help along the healing process. Physical rehabilitation may be helpful as well, and sometimes is necessary to ensure the bone, and any affected cartilage and ligaments, heals properly and without complications.
Should you suffer a mild bone bruise, the pain will in most instances go away in a few days. If the bruise is more severe, the pain can linger for weeks, and even months. That is why a deep bruise, like those that frequently occur in the heel bone, can make walking painful for what may seem like forever.