eMedicine Specialties > Sports Medicine > Introductory Topics in Sports Medicine

Contusions: Multimedia

Author: Michael A Herbenick, MD, Assistant Professor of Orthopedic Surgery and Sports Medicine, Wright State University School of Medicine; Consulting Surgeon, Department of Orthopedic Surgery, Miami Valley Hospital
Coauthor(s): Michael S Omori, MD, Attending Staff, Emergency Medicine Residency, St Vincent Mercy Medical Center; Acting Director, Pediatric Emergency Center, Mercy Children's Hospital; Clinical Assistant Professor, Department of Surgery, University of Toledo Medical Center, The University of Toledo College of Medicine; Paul Fenton, MD, Assistant Professor, Department of Orthopaedic Surgery, Division of Sports Medicine, Medical College of Ohio at Toledo
Contributor Information and Disclosures

Updated: Apr 17, 2009

Multimedia

(Enlarge Image)

Media file 1: Athlete with a quadriceps strain. Place knee passively in 120º of flexion and immobilize with a double elastic wrap in a figure-8 fashion. This should occur within minutes of the injury. Used with permission courtesy of John Aronen, MD.

[ CLOSE WINDOW ]

Athlete with a quadriceps strain. Place knee passively in 120º of flexion and immobilize with a double elastic wrap in a figure-8 fashion. This should occur within minutes of the injury. Used with permission courtesy of John Aronen, MD.

(Enlarge Image)

Media file 2: Modified treatment of quadriceps contusion. Used with permission courtesy of John Aronen, MD.

[ CLOSE WINDOW ]

Modified treatment of quadriceps contusion. Used with permission courtesy of John Aronen, MD.

(Enlarge Image)

Media file 3: Rotator cuff injury.

[ CLOSE WINDOW ]

Rotator cuff injury.

(Enlarge Image)

Media file 4: In this patient's shoulder radiography, the humeral head no longer matches up with the glenoid because the rotator cuff is torn and the strong deltoid muscle is pulling the head superiorly toward the acromion. Courtesy of Dr Thomas Murray, Orthopaedic Associates of Portland.

[ CLOSE WINDOW ]

In this patient's shoulder radiography, the humeral head no longer matches up with the glenoid because the rotator cuff is torn and the strong deltoid muscle is pulling the head superiorly toward the acromion. Courtesy of Dr Thomas Murray, Orthopaedic Associates of Portland.

(Enlarge Image)

Media file 5: Lateral view of the neck showing calcification in the paraspinal muscles. Image contributed by Ajay K. Singh, MD, William Beaumont Hospital, Royal Oak, Mich.

[ CLOSE WINDOW ]

Lateral view of the neck showing calcification in the paraspinal muscles. Image contributed by Ajay K. Singh, MD, William Beaumont Hospital, Royal Oak, Mich.

(Enlarge Image)

Media file 6: A 6-year-old girl who presents a few days after being disciplined on the buttocks with a wooden spoon by her mother. This pattern of bruises is of suspicious shape, number, and location.

[ CLOSE WINDOW ]

A 6-year-old girl who presents a few days after being disciplined on the buttocks with a wooden spoon by her mother. This pattern of bruises is of suspicious shape, number, and location.

(Enlarge Image)

Picture of compartment pressure measuring device for use when commercial devices are unavailable.

[ CLOSE WINDOW ]

Picture of compartment pressure measuring device for use when commercial devices are unavailable.

(Enlarge Image)

Media file 8: Stryker STIC Monitor. Image courtesy of Stryker Corporation, used with permission.

[ CLOSE WINDOW ]

Stryker STIC Monitor. Image courtesy of Stryker Corporation, used with permission.

(Enlarge Image)

Media file 9: An illustration that depicts measurement of compartment pressures in the forearm.

[ CLOSE WINDOW ]

An illustration that depicts measurement of compartment pressures in the forearm.

(Enlarge Image)

Media file 10: Anteroposterior radiograph of the right hip in a 16-year-old boy who had suffered trauma to the hip 2 years previously (same patient in Images 10-11). The patient is currently experiencing hip pain. Mature heterotopic ossification (arrowheads) projects over and lateral to the femoral head.

[ CLOSE WINDOW ]

Anteroposterior radiograph of the right hip in a 16-year-old boy who had suffered trauma to the hip 2 years previously (same patient in Images 10-11). The patient is currently experiencing hip pain. Mature heterotopic ossification (arrowheads) projects over and lateral to the femoral head.

(Enlarge Image)

Media file 11: Corresponding lateral view of the right hip (same patient in Images 10-11). Distal to the mature heterotopic ossification (HO) seen on the anteroposterior view (arrowheads) is a subtle area of early mineralization (arrows) consistent with early HO.

[ CLOSE WINDOW ]

Corresponding lateral view of the right hip (same patient in Images 10-11). Distal to the mature heterotopic ossification (HO) seen on the anteroposterior view (arrowheads) is a subtle area of early mineralization (arrows) consistent with early HO.

More on Contusions

Overview: Contusions

Differential Diagnoses & Workup: Contusions

Treatment & Medication: Contusions

Follow-up: Contusions

Multimedia: Contusions

References

Best TM. Soft-tissue injuries and muscle tears. Clin Sports Med. Jul 1997;16(3):419-34. [Medline].
Kasemkijwattana C, Menetrey J, Somogyl G, et al. Development of approaches to improve the healing following muscle contusion. Cell Transplant. Nov-Dec 1998;7(6):585-98. [Medline].
Nozaki M, Li Y, Zhu J, et al. Improved muscle healing after contusion injury by the inhibitory effect of suramin on myostatin, a negative regulator of muscle growth. Am J Sports Med. Dec 2008;36(12):2354-62. [Medline].
Jackson DW, Feagin JA. Quadriceps contusions in young athletes. Relation of severity of injury to treatment and prognosis. J Bone Joint Surg Am. Jan 1973;55(1):95-105. [Medline]. [Full Text].
Rothwell AG. Quadriceps hematoma. A prospective clinical study. Clin Orthop Relat Res. Nov-Dec 1982;171:97-103. [Medline].
Ryan JB, Wheeler JH, Hopkinson WJ, Arciero RA, Kolakowski KR. Quadriceps contusions. West Point update. Am J Sports Med. May-Jun 1991;19(3):299-304. [Medline].
Cohen SB, Towers JD, Bradley JP. Rotator cuff contusions of the shoulder in professional football players: epidemiology and magnetic resonance imaging findings. Am J Sports Med. Mar 2007;35(3):442-7. [Medline].
Farges MC, Balcerzak D, Fisher BD, et al. Increased muscle proteolysis after local trauma mainly reflects macrophage-associated lysosomal proteolysis. Am J Physiol Endocrinol Metab. Feb 2002;282(2):E326-35. [Medline]. [Full Text].
MacAuley D. Do textbooks agree on their advice on ice?. Clin J Sport Med. Apr 2001;11(2):67-72. [Medline].
Deal DN, Tipton J, Rosencrance E, Curl WW, Smith TL. Ice reduces edema. A study of microvascular permeability in rats. J Bone Joint Surg Am. Sep 2002;84-A(9):1573-8. [Medline].
Hubbard TJ, Denegar CR. Does cryotherapy improve outcomes with soft tissue injury?. J Athl Train. Sep 2004;39(3):278-9. [Medline]. [Full Text].
Schwartz AJ, Ricci LR. How accurately can bruises be aged in abused children? Literature review and synthesis. Pediatrics. Feb 1996;97(2):254-7. [Medline].
Kneeland JP. MR imaging of muscle and tendon injury. Eur J Radiol. Nov 1997;25(3):198-208. [Medline].
Kneeland JB. MR imaging of sports injuries of the hip. Magn Reson Imaging Clin N Am. Feb 1999;7(1):105-15, viii. [Medline].
Bencardino JT, Rosenberg ZS, Brown RR, et al. Traumatic musculotendinous injuries of the knee: diagnosis with MR imaging. Radiographics. Oct 2000;20 Spec No:S103-20. [Medline]. [Full Text].
Wilkin LD, Merrick MA, Kirby TE, Devor ST. Influence of therapeutic ultrasound on skeletal muscle regeneration following blunt contusion. Int J Sports Med. Jan 2004;25(1):73-7. [Medline].
Rantanen J, Thorsson O, Wollmer P, Hurme T, Kalimo H. Effects of therapeutic ultrasound on the regeneration of skeletal myofibers after experimental muscle injury. Am J Sports Med. Jan-Feb 1999;27(1):54-9. [Medline].
Beiner JM, Jokl P, Cholewicki J, Panjabi MM. The effect of anabolic steroids and corticosteroids on healing of muscle contusion injury. Am J Sports Med. Jan-Feb 1999;27(1):2-9. [Medline].
Mishra DK, Friden J, Schmitz MC, Lieber RL. Anti-inflammatory medication after muscle injury. A treatment resulting in short-term improvement but subsequent loss of muscle function. J Bone Joint Surg Am. Oct 1995;77(10):1510-9. [Medline]. [Full Text].
Powell JW, Barber-Foss KD. Injury patterns in selected high school sports: a review of the 1995-1997 seasons. J Athl Train. Jul 1999;34(3):277-84. [Medline]. [Full Text].
Punwar S, Hall-Craggs M, Haddad FS. Bone bruises: definition, classification and significance. Br J Hosp Med (Lond). Mar 2007;68(3):148-51. [Medline].
Rahusen FT, Weinhold PS, Almekinders LC. Nonsteroidal anti-inflammatory drugs and acetaminophen in the treatment of an acute muscle injury. Am J Sports Med. Dec 2004;32(8):1856-9. [Medline].
Sun JH, Wang YY, Zhang L, et al. Time-dependent expression of skeletal muscle troponin I mRNA in the contused skeletal muscle of rats: a possible marker for wound age estimation. Int J Legal Med. Jan 28 2009;epub ahead of print. [Medline].
Thorsson O, Rantanen J, Hurme T, Kalimo H. Effects of nonsteroidal antiinflammatory medication on satellite cell proliferation during muscle regeneration. Am J Sports Med. Mar-Apr 1998;26(2):172-6. [Medline].
Wankhede AG. The bruise which depicted the pattern of subjacent bone. Forensic Sci Int. Apr 15 2009;186(1-3):e5-7. [Medline].

[ CLOSE WINDOW ]

Keywords

contusions, bruises, bruising, muscle contusions, hematomas, soft-tissue injuries, ecchymosis, myositis ossificans, heterotopic ossification, compartment syndrome

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Michael A Herbenick, MD, Assistant Professor of Orthopedic Surgery and Sports Medicine, Wright State University School of Medicine; Consulting Surgeon, Department of Orthopedic Surgery, Miami Valley Hospital
Michael A Herbenick, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, and American Orthopaedic Society for Sports Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Michael S Omori, MD, Attending Staff, Emergency Medicine Residency, St Vincent Mercy Medical Center; Acting Director, Pediatric Emergency Center, Mercy Children's Hospital; Clinical Assistant Professor, Department of Surgery, University of Toledo Medical Center, The University of Toledo College of Medicine
Michael S Omori, MD is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Paul Fenton, MD, Assistant Professor, Department of Orthopaedic Surgery, Division of Sports Medicine, Medical College of Ohio at Toledo
Paul Fenton, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Joseph P Garry, MD, FACSM, FAAFP,, Director of Sports Medicine and Sports Medicine Fellowship, Associate Professor of Family Medicine and Exercise and Sport Science, Department of Family Medicine, East Carolina University Brody School of Medicine
Joseph P Garry, MD, FACSM, FAAFP, is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Heart Association, American Medical Society for Sports Medicine, and North American Primary Care Research Group
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Search for CME/CE on This Topic »

CLOSE [X]
SPECIALTY SITES Allergy & Clinical Immunology Anesthesiology Cardiology Critical Care Dermatology Diabetes & Endocrinology Emergency Medicine Family Medicine Gastroenterology General Surgery Hematology-Oncology HIV/AIDS Infectious Diseases	Internal Medicine Lab Medicine Nephrology Neurology Ob/Gyn & Women's Health Oncology Ophthalmology Orthopaedics Pathology & Lab Medicine Pediatrics Plastic Surgery & Aesthetic Medicine Psychiatry & Mental Health Public Health & Prevention Pulmonary Medicine	Radiology Rheumatology Surgery Transplantation Urology Women's Health OTHER SITES Business of Medicine Medscape Today Med Students Nurses Pharmacists

eMedicine Specialties > Sports Medicine > Introductory Topics in Sports Medicine

Contusions: Multimedia

Multimedia

Athlete with a quadriceps strain. Place knee passively in 120º of flexion and immobilize with a double elastic wrap in a figure-8 fashion. This should occur within minutes of the injury. Used with permission courtesy of John Aronen, MD.

Modified treatment of quadriceps contusion. Used with permission courtesy of John Aronen, MD.

Rotator cuff injury.

In this patient's shoulder radiography, the humeral head no longer matches up with the glenoid because the rotator cuff is torn and the strong deltoid muscle is pulling the head superiorly toward the acromion. Courtesy of Dr Thomas Murray, Orthopaedic Associates of Portland.

Lateral view of the neck showing calcification in the paraspinal muscles. Image contributed by Ajay K. Singh, MD, William Beaumont Hospital, Royal Oak, Mich.

A 6-year-old girl who presents a few days after being disciplined on the buttocks with a wooden spoon by her mother. This pattern of bruises is of suspicious shape, number, and location.

Picture of compartment pressure measuring device for use when commercial devices are unavailable.

Stryker STIC Monitor. Image courtesy of Stryker Corporation, used with permission.

An illustration that depicts measurement of compartment pressures in the forearm.

Anteroposterior radiograph of the right hip in a 16-year-old boy who had suffered trauma to the hip 2 years previously (same patient in Images 10-11). The patient is currently experiencing hip pain. Mature heterotopic ossification (arrowheads) projects over and lateral to the femoral head.

Corresponding lateral view of the right hip (same patient in Images 10-11). Distal to the mature heterotopic ossification (HO) seen on the anteroposterior view (arrowheads) is a subtle area of early mineralization (arrows) consistent with early HO.

More on Contusions

References

Further Reading

Keywords

Contributor Information and Disclosures

Author

Coauthor(s)

Medical Editor

Pharmacy Editor

CME Editor

Chief Editor