Ask a Podiatrist: What is a Bone Bruise?

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Virtually everyone is familiar with a bruise on the skin, but did you know that it’s also possible to suffer a bone bruise? Human bone is a composite of different kinds of tissue. A thin layer known as periosteum provides a covering for the bones. Within the bone is the medulla, comprising the bone marrow and fibrous tissue, the trabeculae.

A bone bruise (also known as a bone contusion) is a minor but traumatic injury to a bone, normally occurring on the bone surface. A bruise is used to describe an injury that affects or damage some of the trabeculae, whereas in a bone fracture, the entire trabeculae are damaged. Bone contusions may also cause bleeding and swelling between the cartilage and the underlying bone.

Any bone in the body can suffer a bruise, but it’s more common in bones that are just beneath the skin’s surface, as they are more likely to suffer direct trauma.

Causes and Symptoms of Bone Bruises

Different types of activities or traumatic injury can result in a bone bruise. Examples include injuries sustained in athletic activities, falling from a height, and motor vehicle accidents. It’s also possible to suffer a bone contusion from twisting injuries and in association with arthritic conditions.

A bone bruise is only visible through Magnetic Resonance Imaging (MRI), though it can also be diagnosed without an MRI. It can be distinguished from a ‘skin bruise” by the following symptoms.

  • Difficulty using an injured joint or body part
  • Swelling or stiffness in a joint
  • Change in skin color around the injury
  • Tenderness and pain that lasts longer than usual. For example, a bruise on the knee could result in fluid collection in the knee.
  • This can be extremely painful.
  • Lastly, Osteoarthritis may also lead to bone bruise primarily because bone protective coverings are damaged and the bones rub against each other.

Are you at risk of a bone bruise?

Bone bruises are relatively common. Anyone can suffer a bone bruise, with the knees and heels especially susceptible as a result of the repetitive impact they can be subjected to.

You may be at elevated risk for bone contusions if you:

  • engage in physical activity, especially contact sports
  • work at a physically demanding job
  • Ignore recommendations to wear protective gear

Treatment and Management of bone bruise

  • Taking medications prescribed by doctors (typically an NSAID like ibuprofen)
  • Resting the affected bone or joint. Stay off the affected part as much as possible and avoid engaging in any strenuous activity
  • Icing the affected areas often. Cold therapy treatment will ease pain and inflammation.
  • Wearing a brace or crutches as recommended by your doctor. This will reduce movement and take the weight off the affected part.
  • Elevating the affected part above heart level will reduce pain and swelling.

The healing period for a bone bruise ranges from a few days to few weeks depending on the degree of injury and its location. Healing may be delayed more than normal if you are a smoker. The bone should heal without any complication. However, if the contusion is severe, blood flow to the injured area may be affected, leading to a condition known as avascular necrosis, or death of bone tissue. If there is no improvement and the aforementioned symptoms persist, see your doctor or podiatrist.

As mentioned, bone contusions are fairly common. But while some will come and go without a problem, others require treatment. If you’ve experienced a bruise on the foot or ankle that affects your mobility or range of motion, schedule an appointment with Dr. Gabriel Maislos, DPM, FACFAS. This is especially important if you suffer from peripheral neuropathy, poor circulation or if you are diabetic.

Call (713) 541-3199 if you experience:

  • deep, slow-healing bruise
  • limited mobility or range of motion
  • discoloration and swelling due to trauma

Houston Foot and Ankle