What is a bone bruise?
A bone bruise is a traumatic injury to a bone that is less severe than a bone fracture.
You might think of a black and blue mark on your skin when you hear the word bruise,
but bruises can also happen in muscle and bone. This happens when an injury damages
small blood vessels and causes blood and fluid to leak into the nearby tissues and
Bone is made of different kinds of tissue. The periosteum is a thin layer of tissue
that covers most of a bone. Where bones come together, there is usually a layer of
cartilage at the edges. The bone here is called subchondral bone. Deep inside the
bone is an area called the medulla. It contains the bone marrow and fibrous tissue
With a bone fracture, all of the trabeculae in a region of bone have broken. But with
a bone bruise, an injury only damages some of these trabeculae. An injury might cause
blood to build up in the area beneath the periosteum. This causes a subperiosteal
hematoma, a type of bone bruise. An injury might also cause bleeding and swelling
in the area between your cartilage and the bone beneath it. This causes a subchondral
bone bruise. Or bleeding and swelling can happen in the medulla of your bone. This
is called an interosseous bone bruise.
The term bone bruise is fairly new. This is because healthcare providers only started
diagnosing the injury when the use of magnetic resonance imaging (MRI) became more
common in recent years. A bone bruise doesn’t show up on an X-ray.
Bone bruises are fairly common. They can happen to people of all ages. Any type of
bone in your body can get a bone bruise. Other injuries often happen along with a
bone bruise, such as damage to nearby ligaments.
What causes a bone bruise?
Injury of any kind can cause a bone bruise. Sports injuries, motor vehicle accidents,
or falls from a height can cause them. Twisting injuries—such as those that cause
joint sprains—can also cause a bone bruise. Medical conditions such as arthritis may
also lead to a bone bruise. This is because where there’s arthritis, bone surfaces
are not protected and they grind against each other. Child abuse is another cause
of multiple bone bruises.
What are the risks for a bone bruise?
You may be at higher risk for a bone bruise if you don’t use the proper safety gear
for your sport. Other risky actions, such as not wearing a seatbelt, may also raise
your risk for a bone bruise.
What are the symptoms of a bone bruise?
Symptoms of a bone bruise can include:
- Pain and tenderness in the injured area
- Swelling in the area and soft tissues around it
- Change in color of the injured area
- Swelling of an injured joint
- Stiffness of an injured joint
This pain is often more severe and lasts longer than a soft tissue injury. How severe
your symptoms are and how long they last depend on how severe the bone bruise is.
How is a bone bruise diagnosed?
Your healthcare provider will ask you about your medical history and symptoms. He
or she will ask how you got your injury. You’ll be given an exam of the injured area
that checks for pain, bruising, and swelling.
After the exam, your healthcare provider may be able to tell if you have a bone bruise.
A bone bruise doesn’t show up on an X-ray. But you may be given an X-ray to rule out
a bone fracture. A fracture may need a different kind of treatment. An MRI can confirm
a bone bruise. But your healthcare provider will likely only give you an MRI if your
symptoms don’t get better.
How is a bone bruise treated?
Treatment for a bone bruise may include:
- Resting the bone or joint
- Applying ice to the area several times a day
- Raising the injury above the level of your heart to reduce swelling
- Medicine to reduce pain and swelling
- Wearing a brace or other device to limit movement, if needed
Your healthcare provider may give you advice about your diet. This is because eating
a diet that is rich in calcium, vitamin D, and protein can help you heal. Your healthcare
provider may ask you to not use certain over-the-counter medicines for pain. Some
of these may delay normal bone healing. If you smoke, your healthcare provider will
advise you to stop smoking. Smoking can also delay bone healing.
Your healthcare provider will tell you how long you should avoid putting weight on
your bone. Most bone bruises slowly heal over 1 to 2 months. A larger bone bruise
may take longer to heal. You may not be able to return to sports activities for weeks
or months. If your symptoms don’t go away, your healthcare provider may give you an
What are the complications of a bone bruise?
Most bone bruises heal without any problems. If your bone bruise is very large, your
body may have trouble getting blood flow back to the area. This can cause avascular
necrosis of the bone. This leads to death of that part of the bone.
When should I call the healthcare provider?
Call your healthcare provider if your symptoms don’t start to get better in a few
days. Call him or her right away if you have any severe symptoms, such as a high fever.
Key points about bone bruise
A bone bruise is a type of traumatic injury. It is less severe than a bone fracture.
It causes blood and fluid to build up at in and around your injured bone:
- You may have symptoms such as pain, swelling, and a change in color of the injured
- Your healthcare provider will need to rule out other medical problems, such as a bone
- A bone bruise can only be seen on an MRI. But it can be diagnosed and treated without
- Your healthcare provider may treat your bone bruise with rest, ice, pain medicines,
and a brace to prevent the bone from moving.
- In rare cases, a bone bruise may cause a complication called avascular necrosis. This
causes part of the bone to die.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also
know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that