Joint contusion

A joint contusion is a serious injury that, unlike a soft tissue contusion, can result in hemarthrosis or hemorrhage into the joint cavity. As a rule, a joint contusion is accompanied by severe swelling, severe and long-term pain. Depending on which joint is injured, limited mobility and sometimes complete immobility are possible.

Most often, elbow joints are subject to bruises - they are the leader among all minor joint injuries, in second place is a bruise of the knee joint. No less dangerous is a bruise of the hip joint, especially in older people, whose skeletal system is extremely vulnerable and at risk of fractures.

In traumatology practice, it is important to differentiate joint contusions from dislocations and sprains, which often accompany such injuries. It is not so difficult to independently distinguish a joint contusion from more serious injuries: with a contusion, the pain symptom is not so intense, in addition, the pain subsides after a few hours, which does not happen with a dislocation or sprain. Also, a contusion is rarely accompanied by hemarthrosis, and a ligament rupture is almost always adjacent to joint hemorrhage.

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Contusion of the joint in the hip area

A contusion of the hip area is an injury to the soft tissues located above the bony, femoral prominences. The most commonly injured areas are the trochanter of the femur, the anterior part of the thigh, and the sciatic nerve (tuberosity) area. In addition to the fact that the injured person experiences pain at the moment of impact, he most often becomes immobilized. Even if the leg is motionless, at rest, any pressure, palpation, or muscle tension causes pain. If the ischial tuberosity is damaged, the person begins to limp, since the soft tissues injured in this area are directly related to walking motor activity. If the ilium is injured, pain occurs when the hips are abducted, for example, when bending or squatting. The injured anterior part of the femoral surface gives off pain symptoms when bending or unbending the leg, shin. Almost all contusions of the hip joints are accompanied by swelling and hematomas.

A hip joint contusion is diagnosed using a simple scheme: collecting anamnestic information, X-ray of the pelvic bones, and if comminuted fractures are suspected, a computed tomography scan may be prescribed.

Complications of a hip joint contusion are quite rare, a common consequence of such an injury is the pinching of muscle tissue in the fascial zones (beds). In traumatology practice, this phenomenon is called subfascial syndrome. In addition, a contusion can provoke calcification (ossification) of deep areas of the thigh muscles, such ossifications are removed using surgical methods. However, a serious complication of a contusion called Morel Lavallee disease also occurs infrequently. This disease is characterized by intense peeling of the skin after a strong blow. The syndrome is also called "wheel noise", since most often the injury is caused by the mechanical impact of a wheel of transport - a car, a bus. This syndrome is little studied, but it is often missed in the diagnostic complex. Detachment, and then necrosis of soft tissues begins unnoticed, but develops rapidly. The first type of injury, which provokes a joint contusion, refers to the crushing of the fat layer. The second type refers to crushing of the fatty tissue, when the fatty layer alone remains intact. The third type is a combined compression of subcutaneous tissues, including the fatty layer, and the cellulose, and deep tissues. Morel Lavallee syndrome is often found in elderly patients, when lymph and blood accumulate between the compressed tissues of the thigh, unable to dissolve due to poor vascular conductivity and general loss of elasticity.

Treatment that involves a hip joint contusion usually refers to conservative methods. The standard scheme shown for contusions also works in cases of hip injuries: rest, cold for the first day, limb fixation. Non-steroidal anti-inflammatory drugs such as diclofenac, ibuprofen are prescribed, and painkillers - ketanov, spazmalgon - may also be prescribed. After two days, you need to begin restoring mobility with the help of special corrective exercises for muscle stretching. At the same time, you can rub the bruised area with gels and ointments - Diclac, Dolobene, Voltaren. The period of restoration of mobility depends on the severity of the injury; often, elderly people have to use a stick and even crutches for several weeks to reduce the dynamic load on the joint.

Elbow joint contusion

A bruised elbow joint is very painful, most often it is provoked by a blow in the sagittal plane (in front and in the middle of the joint). The elbow joint is a complex anatomical structure, so many of its components are injured at once - synovial membranes, articular cartilage, often the fibrous capsule and even bone tissue.

The symptoms that characterize a bruised elbow joint do not require differentiation, they are so intense. The first thing a person feels is a piercing pain, if a nerve is affected, the pain becomes severe and does not subside for a long time. A severe bruise is accompanied by swelling of the elbow tissues, hematomas in this area are rare. Growing swelling can interfere with flexion movements. A bruised joint itself is not dangerous if it does not affect the cartilage tissue. If it is injured, cartilage destruction is possible, which in turn provokes the development of deforming arthrosis. A bruise can also be accompanied by subchondral hemorrhages, since the subchondral plate contains many capillaries and nerve endings. One of the serious complications of an elbow bruise can be hemarthrosis - an accumulation of blood in the joint cavity.

A contusion of the elbow joint is diagnosed in the same way as other injuries that need to be differentiated from dislocations or sprains of the ligamentous apparatus. The circumstances of the contusion are determined, anamnestic information is collected, and, if necessary, an X-ray examination is performed.

Elbow joint contusion is treated in a complex manner. Therapeutic actions include fixation of the joint with a splint, cold compresses on the first day, and possibly application of absorbable drugs such as Troxevasin. Severe pain can be relieved by taking a tablet of ketanov or ibuprofen. In the future, oral administration of anti-inflammatory nonsteroidal drugs and chondroprotectors is indicated.

Knee joint contusion

The knee suffers from injuries as often as the elbow. There are more soft tissues in the knee area, so in addition to pain and swelling, a bruise is also accompanied by hematomas. Moreover, the knee joint is one of the largest and most complex joints in the body, its work involves the patella, tibia and femur. The knee joint is covered with cartilage tissue and is attached by ligaments. Inside the joint bag there is synovial fluid, which helps the joint "slide", in addition, the stable functioning of the knee depends on the condition of the cartilaginous plates - menisci, shock-absorbing and distributing the motor load. The entire structure of the knee joint can be injured either partially or in combination with a bruise, especially if the blow was strong.

Symptoms and diagnosis of knee joint contusion

A common joint contusion is not dangerous if the swelling in the knee area is small, there are no hematomas, and the pain goes away within an hour. If the blow was strong, the joint swells greatly, its contours are smoothed out due to the accumulation of lymph in the subcutaneous tissue, and a developing hematoma is often visible. In addition to swelling, the contusion is accompanied by prolonged pain and difficulty in movement. Hemarthrosis is possible, which is determined by balloting the patella: the limb is straightened, gently pressing on the patella area so that it is completely immersed in the joint cavity. If there is indeed an accumulation of blood, the patella seems to "float up". Hemarthrosis is one of the most serious complications of a knee contusion, often the fluid that accumulates in the cavity reaches volumes of up to 150 ml. A person cannot straighten the knee, as this causes him severe pain. Also dangerous is a meniscus injury, which can be provoked by even a minor bruise of the joint. Diagnostics includes a visual examination, trauma tests, and mandatory radiography in two projections.

Treatment, which involves a bruise of the knee joint, is quite standard. Mild bruises are treated by fixing the joint, in some cases, applying a wedge shoe is indicated. Cold and rest, as well as taking anti-inflammatory drugs can significantly alleviate the condition of the victim. After two days, you can use ointments that absorb swelling, such as Troxevasin, Heparin gel. Non-steroidal anti-inflammatory drugs are preferably used throughout the recovery period. More serious injuries, which are accompanied by severe swelling and hemorrhage into the joint cavity, involve puncturing to remove fluid.