Originally Posted by drs23
Doc, I know you don't know specifics but what is a "bone bruise"? Is that kinda like a Chester Pitts kinda thing?
We all know how that worked out.
The term bone bruise is a misnomer and makes the injury seem less serious than it is. A so-called bone bruise is actually a fracturing of the inner layer of bone.
ANATOMY OF THE KNEE:
Bones are composed of 2 different types of bony tissue, the compact (cortical) bone and the cancellous (spongy) bone. The compact bone is the outer layer of bone and is highly organized, solid, and extremely strong. When you injure this layer of the bone, it is referred to as a stress or overt fracture. The cancellous bone is the innermost layer of bone. (You may better recognize this layer when it is referred to as the "marrow.") Unlike the outer layer of bone, it is not arranged in concentric layers, but in plates (called trabeculae) which form an irregular meshwork that is neither as organized nor as strong as the outer bone. An injury to this area of the bone represents very small fractures to the trabeculae in the meshwork of the bone and may be referred to as a bone bruise.
This type of injury can be a result of repetitive trauma or stress where the inside of the bone is damaged, resulting in bleeding into the damaged area. It can also happen as a result of acute trauma, where forces are not strong enough to fracture the outer bone, but are strong enough to fracture the inner layer of bone.
In diagnosing this condition, we normally must have a "high suspicion" gained from a combination of patient history and physical examination. This "high suspicion" is very important, since an MRI must be obtained in order to diagnose a fracture to the inner layer of bone. Iinjuries to the inner bone will not be evident on xray or CT scan.
Bracing or other immobilization of the area to allow it time to heal and to protect it from additional injury that can be caused by simply bearing weight on the injured area is a must. Activities also need to be restricted during this healing period, particularly sports play, which can result in additional acute trauma, causing greater injury and/or prolonging the healing time. It is important to understand that recovery can often take several months because the inner layer of bone takes longer to heal than the outer bone.
I can't recall Pitts having a bone bruise. Duane Brown had what the Texans called a minor "bone bruise" during the preseason of 2012, and he missed a week. But I seriously doubt that the correct diagnosis was made in that only "x-rays" were obtained.:
Texans head coach Gary Kubiak is no longer holding his breath after left tackle Duane Brown suffered a lower left leg injury during Wednesday's practice. Brown took a few more reps before bowing out and having his left ankle iced. Lucky for the Texans, Brown's injury turned out to be only a bone bruise. "I don't expect to be out too long," Brown told reporters, adding that he is day to day. "It's extremely scary. Once I got the X-rays and everything came out negative, I was extremely relieved." Kubiak said Brown's leg was rolled up on during practice. "We are lucky. ... He'll probably miss a couple days. ... He's an important piece to the puzzle," Kubiak said. Earlier in the day, before the X-rays, Kubiak said the team was holding their breath on Brown's injury.