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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 increases my child's risk for a contusion?

  • A bleeding disorder that makes him bleed more easily
  • Kidney or liver disease, or an infection
  • A family history of bleeding problems
  • Medicines such as blood thinners or certain over-the-counter medicines and herbal medicines
  • Weakened skin and muscles from poor nutrition

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 healthcare provider may ask about any injuries, infections, or bleeding problems your child had in the past. He 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 may have when he moves the bruised area. Your child may need any of the following tests:

  • Blood tests may be used to check for blood disorders or to see how long it takes for your child's blood to clot.
  • Ultrasound pictures may show how deep the bruise is and if any of your child's organs are injured.
  • X-ray pictures may show any broken bones near the bruise.
  • MRI pictures may show if a hematoma (pooling of blood) has started to form. Your child may be given contrast liquid to help the pictures show up better. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his body.

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:

  • 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.
  • Prescription pain medicine may be given. Do not wait until the pain is severe before you give your child medicine.
  • Aspiration is a procedure to drain pooled blood in your child's muscle. This helps prevent increased pressure in the muscle.
  • Surgery 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?

  • Have your child rest the injured area or use it less than usual. If your child 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. Use crutches or a cane as directed.
  • Apply ice to 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.
  • Use 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 child's skin.
  • Elevate (raise) your child's 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.
  • Do not massage or use heat. Heat and massage may slow healing of the area.
  • Do not let your child stretch injured muscles. Ask your healthcare provider when and how your child may safely stretch after his injury.

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 seek immediate care?

  • 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.

When should I contact my child's healthcare provider?

  • 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.

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.

© 2016 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.

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.