Bruise on the thigh

definition

At a bruise (Hematoma), blood leaks from an injured blood vessel into the surrounding tissue.

Depending on the depth of the injured blood vessel, the blood collects in the subcutaneous fat tissue or in the connective tissue around the muscles (muscle boxes).

Such bruises often occur on the thigh as a result of injuries and external trauma, for example a blow or bumping into hard objects. In these cases one speaks of a Horse kiss. Depending on the extent of the trauma and the size of the injured blood vessel, the bruise on the thigh can take on different sizes and sometimes swell and pain.

In most cases, however, bruises on the thigh heal within two to three weeks without consequences. Specialized phagocytes (macrophages) in the tissue take up the blood residues and utilize them.

See also: How do you treat a bruise?

causes

The most common bruising occurs on the thigh to a corresponding trauma, i.e. an injury in the affected area. This usually occurs in the context of a blunt force on the thigh, which corresponds to a bruise or contusion. An example would be bumping into the edge of a table or an unfortunate fall on a hard object. Bruising is one of the most common consequences of sports injuries. Numerous sports are conceivable here, such as boxing, soccer and ball sports in general, or activities that are at risk of falling, such as skiing or cycling.

Also Operations on the thigh or other medical interventions such as puncturing a vessel in a Cardiac catheterExamination can lead to blood vessels being injured and thus to a bruise on the thigh. The causes mentioned have in common that those affected remember a triggering trauma or an injury in the area of ​​the thigh.

If such a trauma cannot be remembered and there is still a major bruise (possibly repeated), the doctor must have a congenital one Bleeding tendency (Haemophilia). With such a tendency to bleed, so-called minor trauma (e.g. a light bump) leads to large bruises, as the blood does not clot. Something similar occurs in patients taking blood-thinning drugs, for example Marcumar®, ingestion, observed. In this case, the dosage of the drug should be checked.

Duration

An uncomplicated bruise heals depending on size within two to three weeks without consequences. The course takes place in characteristic stages. First, fresh blood leaks into the fat or muscle tissue and the stain appears reddish. As soon as this blood begins to clot, the stain turns purple to bluish in color. As the red blood pigment (hemoglobin) is broken down by several enzymes, the bruise initially turns brown / black, then green and finally yellowish.

On the other hand, if a bruise hardly improves after two weeks, for example because it is particularly large or deep, so a doctor should be consulted. In this case, it may be necessary to insert a drain or, in rarer cases, to remove the bruise surgically. Here the body is unable to break down the clotted blood itself and hardening and remodeling processes can occur in the tissue.

Bruising after exercising

Sports injuries are a common cause of bruising on the thigh. Hitting such as in boxing sports, hard balls or kicks from other players in ball sports such as football can tear blood vessels in the thigh. The result is a bruise, colloquially as well Horse kiss called.

In principle, however, you can get bruises on your thigh in any sport that involves a certain risk of injury. When skiing, cycling or dancing, for example, injuries to small blood vessels in the thigh are conceivable as a result of an unfortunate fall. Often times, due to the high levels of adrenaline during exercise, an injury isn't immediately very painful, and only some time later does the full extent of the bruise become visible.

Bruising after a fall

We usually fall reflexively on our knees when we fall forwards and on our buttocks when we fall backwards. This is where bruises usually form if you fall. However, if you stumble unhappily or fall sideways, you can hit the floor with your thigh first. If you fall on a hard object, the trauma will tear small blood vessels in the thigh and blood will leak into the tissue. The result is a bruise on the thigh. Particularly in older people who fall frequently, attention should be paid to severe pain in the thigh or hip, as there is also an additional pain here Fracture of the hip bone or of the thigh.

Bruising for no apparent cause

In particular, a major bruise on the thigh without previous injury or medical intervention is not normal and should be clarified by a doctor. It is important whether such bruises have occurred more often without trauma, or whether the person affected e.g. frequently has nosebleeds. Abnormally heavy bleeding at the dentist, after an operation or during childbirth is also noticeable. The doctor will also ask about blood deposits in the stool or urine and whether other family members have similar diseases (bleeding disorders). In principle, the coagulation is not intact in such spontaneous bleeding events, which can have several causes. For one, this can be done by taking anticoagulant drugs like Aspirin® (ASS), Marcumar®, Plavix® or Pradaxa®) be the case. On the other hand, there are several congenital coagulation disorders (so the doctor asks about other cases in the family). Severe forms (e.g. haemophilia A or B, so-called hemophilia) are already noticeable in infancy. Finally, a disease in the hematopoietic system (e.g. a bone marrow disease) can be the cause of apparently baseless bruises.

You can find out more about blood thinners here: blood thinner

Bruising after cardiac catheterization

A cardiac catheter examination is usually used to assess the coronary arteries for constrictions with the administration of contrast medium or to measure pressures in the heart. This can be necessary, for example, in the context of a coronary heart disease or a heart attack. The catheter is advanced from the groin over the main artery to the heart. To do this, the artery in the groin must be punctured (the catheter is pushed in here). After the examination, the patient has to lie still and is given a pressure bandage over the puncture site. In some cases, blood will still leak from the small hole at the puncture site in the artery and may form a bruise on the thigh. Smaller bruises and swellings are harmless and resemble the bruise when drawing blood. Larger bruises, on the other hand, should be seen by a doctor, as there is a risk of losing large amounts of blood from the artery. In this case, it is sometimes necessary to surgically remove the bruise.

Symptoms

The leakage of blood into the tissue causes a shapeless discoloration of the affected area, which takes place in characteristic steps. First, fresh blood leaks into the fat or muscle tissue and the stain appears reddish. As soon as this blood begins to clot, the stain turns purple to bluish in color (see also Bruise). When the red blood pigment (hemoglobin) is broken down by several enzymes, the bruise turns brown / black, then green and finally yellowish. In addition, the leaked blood can cause considerable swelling and pain. Depending on the extent, the bruise usually disappears after about two to three weeks without any consequences.

Hardening of the muscles

Due to a corresponding trauma, blood vessels in various tissues often rupture. Many blood vessels that supply the muscles also run in the muscle boxes that contain the thigh muscles. This can also lead to blood leakage and the formation of a bruise. The space occupied by the clotted blood in the box leads to swelling and palpable hardening below the fatty tissue. If this swelling is moderate and the pain is mild, no further measures other than cooling are required. If, however, the pressure within the affected muscle compartment rises sharply due to the leaked blood, pressure (compression) of the supplying vessels can result in an insufficient supply of the muscle with blood and nutrients. In this case, however, the patient feels severe pain, up to paralysis of the leg or numbness in the corresponding region. There is a need for operational action as soon as possible.

diagnosis

A bruise on the thigh is one for every doctor and most of those affected Eye diagnosis. This means that the diagnosis can be made at a glance, since the finding is typical. The diagnosis is often supported by the patient's story (anamnesis) about a trauma or injury. If the doctor wants to determine the exact extent of the bruise under the skin, he can use an ultrasound device. Further diagnostics are usually not required.

If a patient bruises repeatedly without the patient remembering the injury, a blood sample can be used to exclude or diagnose a coagulation disorder. The same applies to poorly adjusted Marcumar patients. Is this Marcumar too high a dose, bleeding occurs spontaneously. The Quick or INR value should be checked quickly in this case, as it can also lead to more dangerous bleeding, for example in the skull.

treatment

It is best to treat a bruise on the thigh immediately after the trauma occurs, before the bruise is fully developed. At this point, the thigh can be cooled with ice. The injured blood vessels contract due to the cold and less blood escapes into the tissue. The ice also relieves pain. Heparin ointment dissolves clots in the bruise and can thus ensure that the bruise disappears faster. Arnica ointment has an analgesic and decongestant effect. For smaller hematomas, this home treatment is sufficient. In the case of deeper and larger hematomas, it may be advisable to consult a doctor. In some cases, the blood has to be drained out of the tissue through a drain (a type of tube). In even rarer cases, the bruise must be surgically removed (surgical hematoma removal).

Kinesio tape

Special taping techniques have also proven effective in treating bruises. The aim here is to keep the pressure in the tissue in the area of ​​the bruise to a minimum. This can reduce pain. However, it cannot be guaranteed whether the bruise will disappear faster with the right adhesive technique. In the case of hematomas, a tape with very slight tension is recommended, for example lymph tapes are suitable. With a little experience or under supervision, those affected can apply the tape themselves. However, if you have no experience with taping, you should rather not experiment. In the worst case, the tape is stuck in such a way that the tissue pressure increases instead of decreasing, which makes the pain worse and delays the bruise from subsiding.

When does an operation have to remove the bruise in the thigh?

In most cases, conservative therapy for bruises in the form of cooling and heparin ointment is sufficient.

One reason why surgical removal of a bruise may be necessary is immediate Proximity of the bruise to a joint (such as knee or hip joint). Deposits of blood in the joint can cause premature disease Joint wear (Osteoarthritis). The latter is associated with chronic pain and limited mobility. Even hematomas that are particularly large or deep should be surgically removed, as they cannot be easily broken down by the body itself.

Another reason for surgical removal of a bruise on the thigh is a threatening one Compartment Syndrome. The leaked blood increases the pressure within a box of the muscles, which means that the supply of blood vessels and nerves is no longer guaranteed. If the person concerned feels severe pain, numbness or paralysis of the affected thigh, a surgeon should be called in as soon as possible.

thrombosis

A Thrombosis is a blood clotoccluding a blood vessel.

In principle, all arteries and veins can be affected, but in this context the term thrombosis mainly refers to venous thrombosis. These arise from an increased tendency to clot. Thrombosis can also be promoted by damage to the inner vessel wall (endothelium) of veins, for example in the context of a bruise or contusion.In the case of very large bruises, it can therefore be considered whether thrombosis injections should be administered prophylactically over a certain period of time. A thrombosis usually occurs within the first four weeks after the trauma.

Overall, the risk of developing a thrombosis from a bruise is lowHowever, the risk can increase if other risk factors (for example, smoking, birth control pills, certain medications, lack of exercise ...) are present.