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Contusion In Children

What is a contusion?

A contusion is a bruise that appears on your child's skin after an injury. A bruise happens when small blood vessels tear but skin does not. When blood vessels tear, blood leaks into nearby tissue, such as soft tissue or muscle.

What causes a contusion?

A hard object or a strained muscle can leave a bruise on your child's skin. A twisted knee or ankle can cause a bone bruise. Your child may get a bruise near an area where he has had blood taken for medical tests.

What are the signs and symptoms of a contusion?

  • Pain that increases when your child touches the bruise, walks, or uses the area around the bruise

  • Swelling or a lump at the site of the bruise, or near it

  • Red, blue, or black skin that may change to green or yellow after a few days

  • Stiffness or problems moving the bruised area of his body

How are contusions diagnosed?

Your child's caregiver may ask about any injuries, infections, or bleeding problems your child has had. Your child's caregiver will check the skin over the injured area. He may touch it to see where it hurts. He may ask your child to point to where it hurts the most. He may also check for problems your child has when he moves the bruised area. Your child may also have any of the following tests. He may be given contrast dye before some tests to help the pictures show up better. Tell the caregiver if your child has ever had an allergic reaction to contrast dye.

  • Blood tests: Your child's blood is checked for blood disorders or to see how long it takes for his blood to clot.

  • X-ray: An x-ray will show any broken bones near the bruise.

  • MRI: This scan uses powerful magnets and a computer to take pictures that may show if a hematoma (pooling of blood) has started to form. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if your child has any metal in or on his body.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures that may show muscle and soft tissue bruises.

  • Bone scan: This is used to look at your child's bones for bruises.

How are contusions treated?

Treatment for your child's bruise will depend on how bad it is and where it is on his body. Treatment may include the following:

  • Medicines:

    • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.

    • Pain medicine: Your child may be given medicine to decrease or take away pain. Do not wait until the pain is severe before you give your child medicine.

  • Aspiration: Pooled blood in your child's muscle is drained to help prevent increased pressure in the muscle.

  • Surgery: This may be done to repair a tear in your child's muscle or relieve pressure in the muscle caused by swelling.

What may help my child's contusion heal?

  • Rest: Your child may need to rest the injured area or use it less than usual. If he bruised his leg or foot, he may need crutches or a cane to help him walk. This will help him keep weight off his injured body part. Have your child use crutches or a cane as directed.

  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it on your child's bruise for 15 to 20 minutes every hour or as directed.

  • Compression: An elastic bandage may be wrapped around a bruised muscle to support the area and decrease swelling. Make sure the bandage is not too tight. You should be able to fit 1 finger between the bandage and your skin.

  • Elevation: Have your child elevate (raise) his injured body part above the level of his heart to help decrease pain and swelling. Use pillows, blankets, or rolled towels to elevate the area as often as you can.

What are the risks of a contusion?

A contusion may cause pain that can last for months to years. A muscle bruise may lead to a hematoma (swelling filled with blood) inside the muscle. A hematoma may lead to a serious condition called compartment syndrome. This is an increase in the pressure inside the muscle that squeezes the nerves. Your child may have pain and not be able to move the injured part. A muscle bruise may also cause a growth in the injured muscle. This may make it harder for your child to move the body part. A bone contusion may cause joint stiffness and pain. Your child may have a hard time moving the injured area because of the swelling. If your child does not receive treatment, his contusion may not heal as quickly or as well.

How can a contusion be prevented?

  • Do not leave your baby alone on the bed or couch: Watch him closely as he starts to crawl, learns to walk, and when he plays.

  • Make sure your child wears proper protective gear: These include padding and protective gear such as shin guards. He should wear these when he plays sports. Teach your child about safe equipment and places to play, and teach him to follow safety rules.

  • Remove or cover sharp objects in your home: As a very young child learns to walk, he is more likely to get injured on corners of furniture. Remove these items, or place soft pads over sharp edges and hard items in your home.

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • The injured area is red and warm to the touch.

  • Your child's symptoms do not improve after 4 to 5 days of treatment.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • Your child cannot feel or move his injured arm or leg.

  • Your child begins to complain of pressure or a tight feeling in his injured muscle.

  • Your child suddenly has more pain when he moves the injured area.

  • Your child has severe pain in the area of the bruise.

  • Your child's hand or foot below the bruise gets cold or turns pale.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.