Knee Injury: Bruising and Swelling After a Fall

Knee contusion with hematoma?

Hello, a few days ago, I had an accident where my motorcycle was unstable while parked, causing it to tip over and fall on me.
At that moment, I felt a lot of pain in my knee (similar to the pain of a scrape or abrasion).
Walking became quite difficult since I was wearing jeans.
Upon closer inspection, there were no visible abrasions, but my knee was swollen.
Squatting and kneeling are very painful, and when I looked at it in the morning, I noticed bruising and more swelling.
It hurts significantly even with gentle pressure, and I'm worried about potential long-term effects.
I'm hesitant to seek treatment from a traditional Chinese medicine practitioner.
Can you tell me what might be happening? Will it heal on its own with a few days of rest? The swollen area feels soft to the touch.
Thank you! ^_^

Xiao Han, 10~19 year old female. Ask Date: 2009/12/22

Dr. Zhou Lizhi reply Orthopedics

Post-traumatic swelling in the knee can be categorized into several components: 1.
superficial soft tissue, 2.
joint effusion, and 3.
fractures.
Generally, after a fracture, there is an inability to move the joint.
Joint effusion typically causes significant swelling and pain, while bruising from superficial soft tissue injury usually results in pain for several days.
It is advisable for individuals to visit an outpatient clinic to confirm the diagnosis and rule out the second and third conditions for safety.

Reply Date: 2009/12/22

More Info

Knee injuries, particularly those resulting from falls or accidents, can lead to a variety of symptoms, including bruising, swelling, and pain. Based on your description, it seems that you experienced a significant impact to your knee when your motorcycle fell on you. This type of trauma can cause soft tissue injuries, which may not always be visible externally, such as bruising or abrasions.

When you mention that your knee is swollen and painful, especially when trying to squat or kneel, this indicates that there may be underlying issues that need to be addressed. The soft, swollen area you feel could be due to fluid accumulation in the joint, known as effusion, which is common after an injury. This can occur due to bleeding into the joint space (hemarthrosis) or inflammation of the soft tissues surrounding the knee.

Bruising, or contusions, occurs when small blood vessels are damaged due to trauma, leading to bleeding under the skin. The fact that you are experiencing pain upon pressure and movement suggests that the injury may involve not just superficial tissues but possibly deeper structures, such as ligaments, tendons, or even the joint capsule itself.
In your case, the absence of visible skin abrasions does not rule out significant internal damage. It's important to consider that injuries to the knee can involve various components, including:
1. Ligament Injuries: The knee has several ligaments, including the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), which can be sprained or torn during trauma. These injuries can lead to instability and pain.

2. Meniscus Tears: The menisci are cartilage structures that act as shock absorbers in the knee. A fall can cause tears in these structures, leading to pain, swelling, and difficulty moving the knee.

3. Bursitis: Inflammation of the bursae (small fluid-filled sacs that cushion the knee joint) can occur after trauma, leading to swelling and pain.

4. Fractures: Although you mentioned that there were no visible fractures on X-ray, it's important to note that some fractures, particularly those involving the knee joint, may not be immediately apparent and can require further imaging studies, such as an MRI, to diagnose.

Given your symptoms, it is advisable to rest the knee and avoid activities that exacerbate the pain. Ice application can help reduce swelling and alleviate pain. Elevating the knee and using compression bandages may also be beneficial. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and inflammation.

However, if the swelling does not subside, if you experience increased pain, or if you notice any instability in the knee, it is crucial to seek medical attention. A healthcare professional may recommend imaging studies to assess for any internal injuries and provide a more definitive diagnosis. Physical therapy may also be beneficial in your recovery, helping to restore strength and range of motion to the knee.

In summary, while some knee injuries can heal with conservative management, others may require more intensive treatment. It is essential to monitor your symptoms closely and consult with a healthcare provider if you have any concerns about your recovery.

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