Timberwolves-Ronny Turiaf

Timberwolves-Ronny Turiaf

According to CBSsports.com, Timberwolves center Ronny Turiaf was diagnosed with a bone bruise in his knee and is out indefinitely. Turiaf suffered the injury during Wednesday’s game against the Pacers. A bone bruise, or bone contusion, refers to areas of localized bony tenderness after a traumatic injury, where there is no X-ray evidence of fracture. These painful injuries, while they can persist for several weeks, usually resolve spontaneously with no further consequences.

There are three kinds of bone bruises:untitled

  • Subperiosteal hematoma - A bone has a thin covering called the periosteum, and a direct force can cause an injury with bleeding beneath this covering, resulting in a subperiosteal hematoma.
  • Interosseous bruise - On the other hand, high compressive forces that are repetitively inflicted on a bone can cause bleeding inside the bone where the marrow is located, causing a bone bruise called interosseous bruising. This commonly occurs in the knees and ankles of professional basketball or football players.
  • Subchondral bruise – Finally, there is the subchondral bruise which occurs between a cartilage and the bone beneath it, causing the cartilage to separate from the bone with bleeding in between.

The term bone bruise is also used to describe a group of traumatic bone lesions which are very different from sub-periosteal hematomas. These injuries are usually not visible on X-ray either, however they do show up on magnetic resonance imaging (MRI). They are a feature of certain common sports injuries, such as ACL injuries, patella dislocations, and occult fractures, to name a few.  

 Causes of Bone Bruise

A bone bruise usually results from either a direct and sudden force or from repetitive compressive forces but are not strong enough to break or fracture a bone. There are many ways one can suffer from a bone bruise. Though occult bone lesions may occur wherever there is direct trauma to bone, most knee and ankle sprains are the result of forceful twisting injuries. It is thought that the bruises are caused as adjacent bones are forcefully impacted (“kissing contusions”). In ACL tears, bone bruises are mainly seen in the lateral tibial plateau (outer top edge/surface of tibia) and femoral condyle (lower end of the femur), which is consistent with the valgus (outward force) mechanism of injury.

Symptoms of Bone Bruise

images2Like most types of trauma, a bone bruise is characterized by pain and swelling. However, the pain involved in a bone bruise tends to be more severe and lasts longer than a soft tissue trauma (like in muscles). When a bone bruise is adjacent to a joint, blood and fluids can spread to the joint, causing it to swell. A bone bruise may cause minimal damage to a bone which may be detected with magnetic resonance imaging (MRI) but not by plain x-rays.

The MRI will show bone bruises as localized abnormalities in the subchondral bone (which is just beneath the joint-lining cartilage) and marrow, because of the increased water content of the injured area. The best MRI images of bone bruises are produced from Short T1 Inversion Recovery [STIR] sequences.

Treatments for Bone Bruise

How quickly a bone bruise heals will clearly depend on the severity of the initial injury, as well as the level of activity during the healing phase. As bone bruising in the knee is so often associated with ligamentous and meniscal damage, it is difficult to attribute clinical symptoms to bruising alone. For this reason MRI is the best way of demonstrating healing.

After a traumatic injury, it is best to rule out a fracture by consulting a doctor who may request tests to be done. When a bone bruise is diagnosed with an MRI, one should rest the involved bone or joint and avoid any type of stress that could impede the healing process.

Immediately after injury, apply an icepack over the injured area to prevent excessive swelling and pain. You may also take anti-inflammatory medications to reduce severe inflammation and pain, which can last for more than a few weeks to a month.

Avoid placing more stress on the bruised bone area to allow adequate healing. A bone bruise heals more slowly than a soft tissue damage. To support and protect a bone near a joint from further trauma, it is advisable to wear a brace.

If you are a smoker, we advise against using tobacco or nicotine, which can delay the healing process, since they constrict blood vessels, thus reducing blood flow to the area.

Provided by Primus Sports Medicine Staff