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Hi All

I have an unusual patient presentation....

55yr old lady in good health, no regular rx. She attended her physio for (r)lateral mall swelling (after many inversion ankle sprains due to a lateral column overload). The physio decided to mobilise the ankle and perform some soft tissue release/massage..

Almost immediately, a 'band' of bruising appeared starting at the lateral mall, moving up the soleus and then up the ITB to the hip. The bruising is tender and about 5mm wide.

Does anyone have any suggestion as to why such a long path and pattern of haematoma was triggered in this case?

Thanks
Pete

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Hi Kahuna:
"Almost immediately, a 'band' of bruising appeared starting at the lateral mall, moving up the soleus and then up the ITB to the hip. The bruising is tender and about 5mm wide."

Are you saying that it progressed "up" against gravity?

Most likely a vein that was ruptured during the "soft tissue massage" - blood running along the fascia plane.

Why 5 mm wide? I can only guess she has a small facia compartment encasing a neurovascular bundle.

Steve

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DrSArbes
Fellow American College of Foot & Ankle Surgeons
Board Certified Foot & Ankle Surgery, ABPS
Adjunct Professor OCPM
Green Bay, Wisconsin, USA