Knee Bruises and Treatment Options for Soft Tissue Injuries

Bruising on the side of the knee due to a contusion?

Hello, doctor.
About a year ago, I was in a car accident, and I developed a bruise on the side of my right knee, which gradually faded to a light gray mark.
However, a lump formed in one area that is very painful to the touch.
After more than six months, the lump has shrunk and is almost gone, but that area still hurts when pressed.
When I pull the skin tight, I notice a dent in the skin, and the muscle underneath feels soft and different from other areas.
I would like to know if there is a way to treat this condition.
I previously consulted an orthopedic doctor who confirmed it is not a bone issue.
Should I see a plastic surgeon for further evaluation? Additionally, I have a six-centimeter scar on my left buttock from a previous surgery that has become wide and thick due to inadequate care, and I occasionally feel itching or sharp pain.
What treatment options are available for this? Thank you!

Niming, 20~29 year old female. Ask Date: 2018/08/14

Dr. Zhou Hongzhang reply Plastic Surgery

1.
This is a scar issue; if the injury was severe initially, the scar may appear more unsightly, and both atrophic and hypertrophic scars can form.

2.
It is important to care for the scar during its initial formation, for at least three months.
If it still looks unsightly afterward, treatment options can be considered.

3.
There are several treatment methods available, such as laser therapy, injections, topical ointments, and even surgery.

4.
You can visit a plastic surgery outpatient clinic for further consultation.

Reply Date: 2018/08/14

More Info

Knee bruises and soft tissue injuries can be quite complex, especially when they lead to persistent pain or changes in the tissue structure. Based on your description, it sounds like you experienced a significant injury to your knee during the car accident, which resulted in a bruise that has since evolved into a more complicated situation with a painful lump and changes in the skin and underlying muscle.

Understanding Your Symptoms
The bruise you initially had is a result of bleeding under the skin due to damaged blood vessels. As the bruise heals, it can change color and eventually fade. However, the persistent lump and the pain you are experiencing could indicate a few possibilities:
1. Hematoma: This is a localized collection of blood outside of blood vessels, which can form after an injury. If a hematoma does not fully resolve, it can lead to a hard lump that may remain tender to the touch.

2. Scar Tissue Formation: After an injury, the body repairs itself by forming scar tissue. This tissue can sometimes be less flexible and may cause discomfort or pain when pressure is applied.

3. Soft Tissue Injury: Damage to the muscles, tendons, or ligaments around the knee can lead to ongoing pain and sensitivity, especially if the injury was significant.

Treatment Options
1. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the knee, improve flexibility, and reduce pain. A physical therapist can provide targeted exercises to help rehabilitate the area.

2. Pain Management: Over-the-counter pain relievers such as NSAIDs (e.g., ibuprofen) can help manage pain and reduce inflammation. However, it’s essential to consult with a healthcare provider before starting any medication.

3. Ultrasound or MRI: If the pain persists or worsens, further imaging studies like an ultrasound or MRI may be warranted to assess the soft tissue structures in more detail. This can help identify any underlying issues that may not be visible on X-rays.

4. Corticosteroid Injections: In some cases, corticosteroid injections can help reduce inflammation and pain in the affected area. This should be discussed with your healthcare provider to determine if it’s appropriate for your situation.

5. Surgical Intervention: If conservative treatments do not provide relief and the lump is causing significant discomfort or functional impairment, surgical options may be considered to remove the lump or repair any damaged tissue.

Addressing the Scar on Your Left Hip
For the scar on your left hip, there are several treatment options available:
1. Scar Management Creams: Over-the-counter silicone gel sheets or creams can help flatten and soften scars over time.

2. Laser Therapy: Dermatologists often use laser treatments to improve the appearance of scars. This can help reduce redness and improve texture.

3. Steroid Injections: If the scar is raised (hypertrophic or keloid), steroid injections can help flatten it.

4. Surgical Revision: In some cases, surgical options may be considered to remove or revise the scar, especially if it is causing discomfort.

5. Consultation with a Dermatologist: Since you mentioned the scar is itchy and painful, it would be wise to consult with a dermatologist who can assess the scar and recommend appropriate treatments.

Conclusion
In summary, your knee symptoms and the scar on your hip warrant further evaluation and possibly treatment. It is advisable to consult with an orthopedic specialist for the knee and a dermatologist for the scar. They can provide tailored recommendations based on a thorough examination and any necessary imaging studies. Early intervention can often lead to better outcomes, so seeking further evaluation is a prudent step.

Similar Q&A

Chronic Knee Pain After Accident: Treatment Options for Soft Tissue Damage

About four years ago, I was involved in a motorcycle accident where my right knee impacted the ground. At that time, I only had abrasions, but over the years, my knee has been painful whenever it is touched. There are no visible injuries, but compared to my left knee, there is a ...

Dr. Wang Zhaomin reply Rehabilitation
It is recommended to use knee braces during exercise and to strengthen thigh muscles to enhance knee joint stability. In conjunction with medication and rehabilitation therapy, this should help alleviate symptoms. However, an accurate assessment can only be made through an in-per...

Effective Rehabilitation Strategies for Knee Bruising After ACL Injury

Hello Dr. Lee: Two months ago, I injured myself while playing basketball. I had X-rays and an MRI at Taichung Veterans General Hospital, and the doctor said there was no bone damage, but I have a torn cruciate ligament and knee contusion. I am currently undergoing strength rehabi...

Dr. Li Weiqiang reply Rehabilitation
Hello: Ultrasound can be used to check for hematoma to determine if drainage is necessary. If not needed, continue rehabilitation. Wishing you peace and health. Sincerely, Dr. Li Wei-Chiang, Director of the Rehabilitation Department, Taoyuan General Hospital, Ministry of Health a...

Managing Knee Pain and Bruising After a Sports Injury

You sustained a kick to the outer side of your knee while playing sports, resulting in slight swelling and bruising. You also experience some sharp pain on the outer side of your knee when going down stairs, and prolonged twisting causes significant discomfort. What should I do n...

Dr. Shi Guozheng reply Orthopedics
If it just happened, you must rest and apply ice and elevate the affected area on the first day. If it has been several days, you can use heat therapy. Pain when going down the stairs may be due to swelling or bruising in the impacted area, and heat therapy can help. You can take...

Understanding Knee Pain: Causes, Care, and When to Seek Help

Hello, Doctor. In January of this year, I had an accident where both of my knees fell vertically to the ground, resulting in extensive bruising on both knees. I had an X-ray taken, and the doctor said there seemed to be no issues, and no treatment was provided. It took about thre...

Dr. Shi Guozheng reply Orthopedics
1. First, observe the situation; if the pain persists, medical attention is necessary. 2. You can wear a knee brace. 3. There is no need to take dietary supplements. 4. You can perform muscle strengthening exercises to enhance the strength of the quadriceps, which will help reduc...