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Girl shows a real contusion or bruise on her hand closeup

A contusion is an injury that occurs when a capillary or blood vessel becomes damaged and starts leaking blood into the surrounding area. The word “contusion” is a medical term for what is commonly known as a  bruise. The bruise is often caused by a blunt force, such as a kick, fall or blow. The escape of blood into the surrounding tissue is accompanied by pain, swelling and discoloration.

There are two types of contusion – those on your bones and those on your muscles or skin tissues.

Bone Contusions

Just like the skin, the bones also contain a collection of tissues and blood vessels. As a result, bone injuries can easily cause blood vessels in a bone to start leaking blood. When this happens, the result is a bone contusion.

This type of injury happens when the bone hits against anything hard enough to crack the cortex.

Possible Causes

Examples of the types of incidents that can lead to this type of injury include:

  • A hard fall;
  • A motor vehicle accident;
  • A sports injury received from a collision with another athlete while playing a contact sport. Alternatively, it can be the result of a collision with an object in or near the playing area, such as the wall surrounding a hockey rink.

Symptoms Of A Bone Contusion

The symptoms of this injury can include some or all of the following:

  • Painful swelling in the region of the injury;
  • Stiffness;
  • Tenderness around the injury;
  • Difficulty using the injured body part, such as a reduction in the range of motion of a joint.

The pain of a bone contusion tends to last longer than that of a soft tissue bruise. The duration of this pain can vary from one to several weeks, depending on severity of the injury and how it is treated.


Bone contusions are impossible to see on an X ray imaging scan. As a result, to diagnose one, the doctor usually has to use a process of elimination; i.e. he or she must progressively eliminate other possible injury causes such as a broken bone. Precise details about how the accident occurred are very important in helping the doctor to determine the actual cause of the injury.

In addition to a process of elimination, doctors may use a more sophisticated scan such as an MRI to detect the presence of a bone contusion.  Although an MRI scan is the only imaging technique which would show a bone contusion, it is not always needed for the diagnosis to be made.

Medical Treatment

Most bone contusions tend to resolve on their own. The time required can range from between a few days for mild bruising and several months for a more severe contusion. To reduce the pain of the injury while healing proceeds, the doctor may prescribe anti inflammatory drugs such as ibuprofen or Advil.

For additional pain and swelling control, the patient can apply a cold pack to the injured area several times a day for periods of up to 20 minutes at a time. Elevation of the affected extremity above the level of the heart can, also, help to reduce swelling.

For some types of bone contusion, doctors may also suggest wearing an orthopedic brace or using dietary supplements that contain vitamin D or calcium. These elements contribute to healthier and stronger bones.

If these treatments fail to resolve the pain and swelling after a few days, the patient should arrange another visit to his or her doctor for further medical advice. Treatment from the doctor is more likely to be needed for more serious contusions.

Soft Tissue Bruises

As we have mentioned above, soft tissue bruises are injuries to muscle or skin tissue that cause bleeding of blood vessels.

Possible Causes

Possible causes of a soft tissue bruise can include:

  • Colliding with something;
  • A hard fall;
  • A ligament injury such as a sprain.
  • Receiving an injection or vaccination;
  • Having your skin pierced in order to donate blood.


The symptoms of a contusion of soft tissue are much easier to spot than those of a bone contusion. They include some or all of the following:

  • Skin discoloration;
  • A small bump over the area of the bruise;
  • Pain that increases when the patient applies pressure to the injured area.

In general, the pain of a soft tissue bruise tends to be more severe than that of a bone tissue contusion.


Soft tissue contusions are almost always treated using the R.I.C.E. protocol:

  • Rest, by avoiding the use of the injured body part for a while;
  • Icing the affected area to reduce swelling several times a day for several minutes at a time. A cold compress can be used instead of an ice pack;
  • Compressing the area with an elastic bandage;
  • Elevating the injured area above heart level whenever possible. This will help to drain blood from the area of the bruise. This will then be replaced by fresh blood, which contains nutrients to promote faster healing.

A soft tissue contusion usually takes from a few days up to about two weeks to heal. They usually heal faster than bone contusions, where the process not infrequently can take up to two months.

As with bone contusions, the patient should consult with the doctor if (s)he does not notice a reduction in pain and swelling after a few days of this treatment.

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