Haematoma – EDP column

“I was running for a bus and ran full speed into a chain between 2 bollards. My thigh swelled up and I was told this is a haematoma. What is this?"

A haematoma is a bleed into some of the tissues. It is a bit like a large bruise where you have bled into the muscles. The blood vessels have burst due to the trauma and It can be very painful. Most of these do not cause any problems, but that depends on where the haematoma has occurred. If it is into the muscle of the thigh – a quadriceps haematoma – then it will take a few weeks to get back to normal. It may be quite stiff and painful for a few weeks, but you should be able to get back to normal.

If the haematoma involves a joint then it may mimic a fracture and it is important you see your doctor because it may be that you will need to see a specialist to determine if further action needs to be taken.

Usually the bleeding stops on its own. Blood in the tissues causes inflammation and swelling. As the tissues heal themselves, there may be some residual fibrous tissue – a tough tissue that does not stretch as well as muscle and you may notice some changes in the contour of your leg muscle.

If any of the blood gets to the skin, it will look like a bruise. As it improves, like any bruise it will change colour because the chemicals in the blood breakdown. It will start as a dark red and then become deep blue or purple. After a week or so it will turn a green colour and eventually a green before eventually fading away after about 3 weeks

Very rarely, the blood in a haematoma does not get absorbed in the body and may form a hard cavity lined by calcium. This is a way the body had of sealing off an area it cannot safely deal with. It does not usually cause any problems, but if the pain or deformity is persistent, then you should see your GP who could organise some scans or an X-ray to see if anything more needs to be done. It is possible to suck some of the fluid out of the haematoma – aspirate it – if it does not resolve of its own accord.