Do I Have a Broken Or Bruised Bone? How to Know For Sure.

The main difference between a fractured bone and a bone bruise is that a fracture results in an actual break in the bone and a bone bruise does not. However, the two have similar symptoms and causes, so it can be hard to tell if a bone is fractured or bruised without a physical examination and/or diagnostic testing (such as an X-ray or magnetic resonance imaging test).

This article will discuss the symptoms of a fracture versus a bone bruise, how each is treated, and when to get emergency care.

Fracture vs Bone Bruise

A fracture occurs when a bone is damaged to the point where it cracks or breaks. Fractures are the same as "broken bones." Fractures range from relatively minor, which include a hairline or stress fracture, to severe. An example of a serious fracture is a compound fracture where the bone may actually penetrate the skin.

A fracture can be caused by an injury, osteoporosis, or repetitive stress on the bone (due to running or jumping, for example).

Bone bruises can also be caused by trauma, injury, or osteoporosis, but instead of actually breaking, the bone gets several tiny cracks in it and blood and fluid build-up under the skin. The most common areas for bone bruising to occur are the knee and ankle.

A hairline fracture in particular may be difficult to distinguish from a bone bruise without an imaging test. More serious fractures typically have more obvious and severe symptoms and are less likely to be confused with a bone bruise.

Symptoms of a Fracture

The symptoms of a fracture may vary depending on how severe it is and where it is located. Common symptoms of a fracture include:

• Swelling, bruising, or bleeding around the area
• Intense pain that may increase with movement
• Numbness and tingling
• Broken skin with bone protruding
• Limited mobility or inability to move a limb or put weight on the leg
• Numbness or tingling (if the fracture is close to a nerve)
• Crepitus, a "crunchy" sensation that occurs when broken bits of bone rub together.

Symptoms of a Bone Bruise

Symptoms of a bone bruise can include:

• Pain and tenderness in the injured area
• Swelling in the area
• Hard lump in the area
• Reddish or bluish discoloration around the area
• Limited range of motion in the affected joint or limb

Diagnosing a Fracture vs a Bone Bruise

When diagnosing a fracture or a bone bruise, your healthcare provider will start by asking you questions about how and when the injury occurred as well as your symptoms. They will then do a physical examination of the area, looking for swelling, bruising, and tenderness.

Imaging tests are also helpful to differentiate a fracture and a bone bruise. An X-ray can reveal a fracture, but magnetic resonance imaging (MRI) is necessary to identify a bone bruise.

If your healthcare provider suspects you have a more severe fracture or your symptoms are caused by another problem, additional testing may be necessary.

How Fractures Are Treated

Initial treatment for a minor fracture includes the RICE protocol, a method of self-care that you can do at home. RICE stands for:

• Rest: Try to avoid using the affected limb as much as possible for 24 to 48 hours.
• Ice: Apply an ice pack to the area for 20 minutes at a time, four to eight times a day.
• Compression: Your healthcare provider may suggest you wrap the area with an ACE bandage, use a splint, or compress the area with another device.
• Elevation: Elevating the affected limb above the heart can help reduce pain and swelling.

Non-steroidal anti-inflammatory medications (NSAIDs)  like Advil (ibuprofen) and Aleve (naproxen sodium) may be helpful for relieving pain. However, these are not always recommended, as anything that stops the inflammatory process, which is the immune system's healing response, can slow down recovery.

Certain types of stress fractures may require casting or, in the case of a foot or leg fracture, crutches.

Healing time depends on the location and severity of a fracture. Typically, fractures take six to eight weeks to heal. More serious fractures can take longer.

How Bone Bruises Are Treated

Treatment for a bone bruise is comparable to treatment for a fracture. The RICE method is also recommended as the first-line treatment; as with fractures, you may be advised not to take NSAIDs, as some of these may delay normal bone healing.

Your healthcare provider will tell you how long to avoid putting weight on the affected bone (again, crutches may be necessary if the bruise affects your foot or leg). Most bone bruises heal within four to eight weeks.

Summary

A minor fracture (such as a stress fracture) can be hard to tell from a bone bruise because they cause similar symptoms, including swelling and pain. The main difference is that a fracture results in a break in the bone, while a bone bruise creates tiny cracks in the bone. Healthcare providers can tell the difference by using X-rays and MRIs. In most cases, bone bruises and fractures will heal within a month or two with conservative treatment.