emDocs - Jul 26, 2017 - Authors: Morales J and Williams M
Edited by: Koyfman A and Long B
"Pearls:
- Most extremity hematomas can be managed conservatively without the need for imaging studies.
- Consider imaging if the patient is not improving as expected or concerned for other complicating injury such as fracture, tumor, or arterial vascular injury. Musculoskeletal ultrasound has been found to be a useful tool in evaluating hematomas, muscle contusions and other muscle injuries but is operator dependent. Soft tissue MRI generally not indicated in the ED setting.
- Myositis ossificans takes approximately 6 weeks to be visualized on plain film.
- Have a low threshold to evaluate for developing compartment syndrome if suspicious based on clinical findings.
- Know potential indications for emergent surgical evacuation and admission.
- Antithrombotic/anticoagulant reversal generally not indicated unless compartment syndrome or hemodynamic instability. Specialist consultation advised to assist with risk/benefit assessment."