Quad Pain

[s24320]

It has been 4 months since I hit my VMO quad hard at my desk.  There is a constant dull pain and at times sharp sensations and tingling and my leg will contract trying to do something.  About 3 weeks ago I was standing and felt something release and felt blood flow down the back of my leg.  I thought this may have been the end of it.  The next morning I woke up and there was a bruise right in the spot where I hit it.  This is the first time there was ever a bruise.  Also the hair in the spot on my VMO were the bruise formed all fell out.  Probably 1 inch in diameter. My quad didn't feel any different though besides the bruise.  Within a week the bruise went away and it is now back to the way it was before except for the hair is gone in that one spot and when I take my fingers and squeeze my skin in that spot without the hair I can feel a small lump under the skin almost like a blood clot or cyst or something but if I don't squeeze it you can't see the bump.  However when I walk my injured VMO flexes much more than my other VMO right in the spot where I hit it.  I have had a MRI on my knee and Quad both coming out negative and not even showing fluid.  I have seen 2 doctors and neither knows what is going on.  I know something isn't right as this hurts constantly.  I have tried physical therapy for 4 weeks and strengthening and not doing anything as well and nothing has worked.  Always is the same constant dull pain whether sitting or standing.  Any help would be appreciated.

[S. Kaul, MD]

Hi there!

What I understand from your description is that you had a quad injury about four months back and no appreciable defect was diagnosed at that time.  Now, about 3 months and a week later, you developed a bruise that healed by itself and then recurred in the absence of any trauma and your quad seems to have lost its tone. Well, localized bruise without trauma if often indicative of a previous injury that has failed to heal completely to get re-traumatized, a connective tissue disorder or a recently developed bleeding tendency. Localised loss of hair over the region could occur with superficial/ deep infections/ inflammations etc. Without an examination and probably a few tests it would be difficult to point a single cause. I wonder if your evaluations by the two doctors were recent or done at the time of injury. I would suggest a re-evaluation by an orthopedician/ sports medicine doctor including blood flow studies in the limb. After an attributable cause is found, it can be managed accordingly.
Hope this was useful.

Take care!

[s24320]

Wouldn't the quad of the MRI shown the hematoma?  Or can this be missed?  Why would the hair in this spot have fallen out and even after it bursted under the skin the pain was still there and days after the bruise went away it was back to the same thing.

[Tulasi P, MBBS]

Hi,


It seems that you had hematoma after hit, it got infected and afterward it burst open.

Go for X-ray and rule out injury to the bone.

Go for antibiotic course and regular dressing.