Features

• It's common among athletes and the average person: an impact to a body part that leaves a bruise. But when that bruise lingers or is especially painful, a bone bruise may be to blame. Bone brusing is caused by trauma, usually impact, to the bone. The outer layer of the bone is damaged, usually with a series of small cracks, but the bone itself has not been fractured. So while the injury itself is relatively minor, the damage and effects can be especially painful.
  
  

Types

• A bone bruise is also known as a periosteal bruise and it occurs when the blood vessels in the outer layer of the bone have been impacted. It is the most painful of the three types of bruises, the other two being subcutanous (directly beneath the skin), and intramuscular (a muscle bruise).
  
  

History

• Bone bruises have a history of being a tough diagnosis. They do not show up on a typical x-ray, and it wasn't until the invention of magnetic resonance imaging (MRI) in the 1980s that doctors were able to diagnose the injury.
  Because MRIs can take a more accurate picture of the injury, doctors were finally able to see that it was not the bone itself that was damaged, but the outer layer that contains and intricate web of blood vessels. The damaging and breaking of these blood vessels are what cause the bruised color to appear on the skin around the injury.
  
  

Misconceptions

• Because a bone bruise is especially painful, it is often mistaken for a bone fracture. The swelling and discoloration that accompany the injury can also lead to the misconception of a fracture. A diagnosis by a licensed physician will clear up the question of whether the injury is a fracture or a bruise.
  
  

Prevention/Solution

• The treatments for a bone bruise are much like the treatments for any other bruise, or any injury that causes swelling. Resting and icing the injury will expedite the healing process. In the meantime, pain relievers and anti-inflammatories will help with the pain. Unfortunately, it can take weeks for the injury to fully heal, and it is often hard to prevent, especially for athletes. The good news is that like with most other bruises, it can heal relatively quickly with proper care.