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Bumps & Bruises
(Contusions & Ecchymoses
A second and much less common problem occurs when the body deposits calcium, the material that makes up the majority of bone, in the area of injury. The area becomes tender and firm. This process is called heterotopic ossification or myositis ossificans. This condition is diagnosed by x-ray and requires a trip to your health care practitioner.
What are some less common causes of bruising and what do they indicate?
The terminology describing different types of bruising often refers to not only their appearance, but also to their cause. Petechiae refer to very small, one to three millimeter, accumulations of blood beneath the skin. These can appear like multiple tiny red dots on any part of the body (most commonly the legs). Most often these are multiple and they can suggest that there is serious health problem present. Examples of these are an infection of the valves of the heart (endocarditis) or abnormal function of the blood clotting elements (platelets). Bruising around the navel (belly button) can be a result of bleeding within the abdomen. Bruising behind the ear (Battle's sign) can indicate that there is a skull fracture. Lastly, bruises that are raised, firm, multiple and occur without any injury can be a sign of various types of "autoimmune" diseases (diseases in which the body attacks its own blood vessels). Each of these should be evaluated by a health care practitioner.
What is the treatment for bruising?
There are a couple of things that you can do to prevent or minimize bruising after an injury. First, try a cold compress. Put ice in a plastic bag, wrap the bag in a towel (applying the ice directly to the skin can cause frostbite), and place it on the injured area. Commercial ice packs are also available, but a bag of frozen peas makes an excellent substitute. It molds to the shape of the injured area and can then be re-frozen and used again (but don't eat them!!). The cold reduces the blood flow to the area and therefore limits bleeding into the skin and reduces the size of the bruise. The cold also decreases the inflammation in the area of the injury and limits swelling in this way as well. If possible, elevate the area above the level of the heart. The lower an extremity is below the heart, the more blood will flow to the area and increase the bleeding and swelling.
Avoid taking the medications listed above that can contribute to bruising. If you have any questions about whether or not your medication can contribute to bruising, ask your health care practitioner or pharmacists. Do not stop any prescription medications without first contacting your health care practitioner. Finally, pressure applied to the area (by hand, not with tourniquets) can reduce bleeding .
People who take medicines that reduce clotting ("blood thinners") or have clotting abnormalities should seek the advice of a physician or other health care provider immediately, as should the elderly or those who have experienced significantly severe trauma.
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