Hard Lumps After Bruising: When to Seek Medical Help - Surgery

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Hematoma after bruising?


Two months ago, I sustained bruises on my knee and ankle due to a car accident.
An X-ray was taken at that time, and there were no issues found.
The bruising has since dissipated, but I can still feel a hard lump at the site of the original bruise on my ankle, which is painful when pressed.
I previously consulted a traditional Chinese medicine practitioner for a month (undergoing electrotherapy and applying medicated plasters), but the treatment effects were not significant, so I stopped.
Should I apply heat therapy myself now, or continue seeking medical attention? Thank you for your response.

Li, 20~29 year old female. Ask Date: 2024/03/07

Dr. Peng Xianwen reply Surgery


Dear Ms.
Li: You may continue with your consultations, but it may not be very helpful.
If you still have concerns regarding medical treatment, it is advisable to return for a discussion with your attending physician.
Director Peng Hsien-Wen, General Surgery, Nantou Hospital.

Reply Date: 2024/03/07

More Info


When dealing with hard lumps after bruising, especially following an injury like a car accident, it’s important to understand the underlying causes and when to seek further medical help. The hard lump you are feeling in your ankle, which remains painful to the touch even after the initial bruising has subsided, could be indicative of several conditions.

Firstly, it’s possible that the hard lump is a result of residual swelling or hematoma formation. A hematoma occurs when blood collects outside of blood vessels, and while it may initially present as a bruise, it can sometimes harden as the body reabsorbs the blood. This process can take time, and in some cases, the lump may remain tender for an extended period.

Another possibility is that the lump could be a fibrous tissue formation, which can occur as part of the healing process. When soft tissue is injured, the body may produce scar tissue as it repairs itself. This scar tissue can sometimes feel firm or hard and may be sensitive to pressure.

Given that you have already sought treatment from a traditional Chinese medicine practitioner without significant improvement, it may be beneficial to consider a few options moving forward:
1. Self-Care Measures: You can certainly try self-care measures such as gentle heat application to the area. Heat can help increase blood flow and promote healing, but it’s essential to ensure that the area is not inflamed or swollen before applying heat. If the lump is still tender, you might want to avoid heat and instead use cold therapy to reduce any inflammation.

2. Monitoring Symptoms: Keep an eye on the lump. If it begins to grow, change in color, or if you experience increased pain, swelling, or any new symptoms (such as fever or redness), it would be wise to seek medical attention promptly.

3. Follow-Up with a Healthcare Provider: Since you had an X-ray that showed no fractures, it might be beneficial to follow up with a healthcare provider, such as an orthopedic specialist. They can evaluate the lump more thoroughly, possibly recommending an ultrasound or MRI to assess the soft tissue and determine if there is any underlying issue that needs to be addressed.

4. Physical Therapy: If the lump is related to soft tissue injury, a physical therapist can provide exercises and treatments to help restore function and reduce pain. They can also guide you on how to manage the lump effectively.

In summary, while self-care measures like heat application can be beneficial, it’s crucial to monitor your symptoms closely. If there is no improvement or if you have concerns about the lump, seeking further evaluation from a medical professional is advisable. They can provide a more accurate diagnosis and recommend appropriate treatment options tailored to your specific situation. Remember, your health and well-being are paramount, and it’s always better to err on the side of caution when it comes to persistent symptoms following an injury.

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