Help me understand what fool thing I did

September 13, 2012 11:08 AM

What horrible injury have I done myself? Not-immediately-threatening bike accident injury question.

A week ago today I was in a pretty serious bike accident. I've had a CAT scan of my head (fine!) and an eye check-up due to some visual symptoms (also fine!). Bruises are large but healing. Generalized soreness is declining. However...

....I have two weird injuries the like of which I've never seen before and which I didn't really realize I had when I saw the doctor. YANMD and neither seems threatening - I'd just like to know what the heck I did to myself.

1. I took a lot of impact on one side of my leg, luckily covered by sturdy pants. I have no bruising at all, but the flesh swelled up a lot and is extremely sore. (Although slowly but steadily improving.) Why did it swell up and hurt but not bruise? How did it swell up and hurt but not bruise?

2. I have a lump in my leg near but not directly beneath a big bruise. It's about an inch long and 1/2 inch wide. It's well under the skin, feels like it's in the fat. I haven't poked at it much. It's a bit sore. It has well-defined edges and it is absolutely in the wrong place (wrong location on leg, wrong depth) to be a DVT/blood clot in the femoral vein. It has no surrounding swelling or redness. I do not know when it developed - if it was there right away or not. I only noticed it three days ago. How did this happen? What is it?

I would rather not go back to the doctor for these things since they seem to be stable or improving and don't seem life-threatening. If they change/get worse, I'll go like a shot, of course, but I've already missed a bunch of work time.

posted by Frowner to Health & Fitness (9 answers total)

Internal bleeding not near the skin could have caused swelling without bruising. It is not necessarily anything to worry about. Take ibuprofen regularly, and if it doesn't get better in a few days, call your doctor and see what they say.

I can't really say what the lump is, though it could also be related to internal swelling or bleeding, in which case the ibuprofen should help it too.

Personally, I wouldn't go back for either unless they get worse. If they do get worse, as you say, go like a shot.
posted by ubiquity at 11:30 AM on September 13, 2012

IANAD, but I would go to the doctor ASAP. The swelling without a bruise and pain could be compartment syndrome, something you wouldn't want to wait to treat. Mark Ellis (formerly of the A's, but now a Dodger) suffered this type if rare injury earlier this year. It could have cost him his leg if he had waited any longer to seek treatment. So my advice is go back to the doctor, because it's better to be safe than sorry.
posted by wherever, whatever at 11:42 AM on September 13, 2012 [1 favorite]

I agree, better safe than sorry.
posted by Dansaman at 12:17 PM on September 13, 2012

Response by poster: See, when I look up compartment syndrome, all the sources agree that it is a medical emergency which needs to be addressed within a few hours and that it hurts like a son-of-a-gun. Since it's been a week since the injury and it's slowly but definitely improving, I just don't see how it could be compartment syndrome. I don't have any of the major symptoms, either - no constant severe pain; pain is present only on pressure or jostling rather than with movement; there's no numbness or pulselessness. (As far as the small, localized lump, that isn't compartment syndrome either - it's too local and too obviously not in the muscle.)

I mean, I'll bear that in mind and be extra careful to go to the doctor if it worsens, but it doesn't seem like the obvious diagnosis. But wow, what an incentive not to have any more bike accidents. Yikes!
posted by Frowner at 12:49 PM on September 13, 2012

Your insurance may also have a nurse line that you can call, and they'll tell you what the best course of action is.
posted by bookdragoness at 1:58 PM on September 13, 2012

I hardly ever bruise but I do swell up. I describe this injury as "a lump" and they typically go away in a week or so. I assume its just non blood fluids.

One of my friends fell off a rock band snowboarding last year and had the entire top of his leg had a giant lump for about a month where he landed on it. It was pretty impressive but it never bruised.
posted by fshgrl at 2:29 PM on September 13, 2012

My mum fell a few years ago and jarred her backside. The lump you describe in 2 sounds like what she got--I think it was described as a fat fracture, so that might be a useful search term or thing to mention to your doctor. It was quite debilitating and I think the lump was apparent for years, possibly even today. I'll ask her for more information tomorrow morning.

I wish you a speedy improvement!
posted by daisyk at 3:06 PM on September 13, 2012

Hello there, glad to hear you're OK after the accident. I am also glad you are a good Googler so that you didn't feel the need to have a painless lump checked for compartment syndrome. Because IANYD and this is the sort of thing where a photo and palpation are worth a thousand words, so I usually hesitate to say much on questions like this at the risk of misinterpreting a potentially serious issue, but that's clearly not compartment syndrome (has zero of the 6 P's of compartment syndrome: pain, pallor, pulselessness, paresthesias (tlngling), paralysis, poikilothermia (fancy word for feeling cold)).

Could the lump be a lipoma you just hadn't noticed before? I have seen many patients who only noticed something like that when they happened to be paying particular attention to that part of their body for some other reason. Or possibly an area of fat necrosis?
posted by treehorn+bunny at 5:01 PM on September 13, 2012

My mother fell off her bicycle and got a hematoma in her thigh muscle. It was deep enough that it didn't show any bruising, and it took forever to go away. It sounds a lot like what you're describing.
posted by KathrynT at 6:49 PM on September 13, 2012