Contusion: what it is, signs and severity

Almost everyone is familiar with a contusion: you hit yourself on the edge of a table, land badly after a jump, catch a ball with your face. Pain appears immediately, and after a few hours swelling and a bruise develop. Below: what happens in the tissues, how to tell a contusion from a more serious injury, and when it is time to see a doctor.

What a contusion is

A contusion (Latin contusio) is a closed injury to tissues and organs without significant disruption of their structure. Superficially located tissues are most often affected: skin, subcutaneous fat, muscles, and periosteum. With a strong blow, soft tissues are pressed against the bones, and that is where the damage increases. Contusions of the skin, muscles, and bones are distinguished; bone contusions are considered the most serious.

Causes and mechanism of a contusion

A contusion occurs from a blow with a blunt object or from a fall. At the moment of injury, small vessels rupture, but the skin remains intact — blood escapes beneath the surface and saturates the tissues. Ongoing bleeding in the depths compresses adjacent tissues, so pain gradually intensifies and function is impaired. Contusions also occur with blast or gunshot trauma, when damage appears at a distance from the point where the force was applied.

Main signs of a contusion: pain, swelling, bruise

The typical triad is pain, swelling, and a bruise. Hemorrhage manifests as a blue-purple spot, the color of which gradually changes to greenish and yellow. Most bruises last about two weeks, but the trace may take months to disappear completely. With a joint contusion, its volume increases after a few hours, and movement becomes sharply painful. With a head contusion there may be only a small "bump," but loss of consciousness, weakness, nausea, and vomiting indicate a concussion or brain contusion.

Degrees of contusion and contusions of different areas

Severity depends on the force of the blow and the area. On the shin, where the skin lies close to the bone, skin necrosis and sloughing are possible. A blow to bones poorly protected by soft tissues causes not only a painful periosteal contusion but also cracks or fractures. A neck contusion can secondarily impair blood flow in the vessels, a back contusion can impair spinal cord circulation, and an abdominal contusion can damage internal organs with internal bleeding.

• Skin and subcutaneous fat — bruise and swelling
• Muscles — pain and impaired function
• Periosteum and bone — sharp pain, risk of cracks
• Joint — increased volume, hemarthrosis
• Internal organs — hidden bleeding

How a contusion differs from a sprain and a fracture

A sprain is an injury to ligaments, while a muscle strain is overstretching or tearing of a muscle; in everyday speech such an injury is called a "pulled" muscle. Such injuries also involve pain, swelling, and a bruise, but it is the ligaments or muscles that are affected, not the tissue under the blow. A fracture reveals itself differently: a crunch is heard at the moment of injury, part of the body changes shape or is positioned at an unnatural angle, numbness and tingling appear, the skin around changes color — becomes blue or gray — or is cold to the touch. In such cases an X-ray is needed.

Possible complications and when to see a doctor

You should see a doctor if the pain is severe or increasing, the swelling and bruise are large or growing, you cannot bear weight on the limb or walk more than a few steps, movement is difficult, and self-care measures do not help. A reason for examination is a high temperature and a feeling of heat or chills: this may indicate an infection. The doctor may refer you for an X-ray or physical therapy.

A contusion by itself is not a reason to call an ambulance. Call 103 or 112 if at the moment of injury there was a crunch, part of the body changed shape or looks twisted at an unnatural angle, numbness or tingling appeared, or the skin around became blue, gray, or cold to the touch.

This material is for reference: it helps you understand what is happening but does not replace a doctor's consultation — the final assessment of the injury is made by a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer