Hip Pointer (Iliac Crest Contusion)

Direct hit (trauma) to the hip bone in the front and side of the body (ilium) may cause hip pointer. This is also called iliac crest contusion. Hip pointer is bruising (contusion) of the skin and underlying tissues of the hip bone. A bruise results from injury to blood vessels, which bleed into the surrounding soft tissues. This gives a "black and blue" look. Since the upper hip bone has little protective covering, it is vulnerable to injury.

SYMPTOMS

  • Swelling, pain, and tenderness of the hip bone.

  • Pain, often worse the day after injury.

  • Feeling of firmness when pressure is placed on the injury site.

  • Discoloration under the skin (redness, turning to "black and blue" or purplish color).

  • Sometimes, pain with walking or inability to walk.

CAUSES

Direct force (trauma) to the hip bone. This may result from collision with another player or the playing surface (i.e. grass, court, ice, sideboard).

RISK INCREASES WITH:

  • Contact or collision sports (i.e. football, hockey, soccer).

  • Poor protection of exposed areas, during contact or collision sports.

  • Bleeding disorder or use of blood thinners (anticoagulants), aspirin, or non-steroidal anti-inflammatory medicines (aspirin and ibuprofen).

PREVENTION

  • Wear properly fitted and padded protective equipment.

  • Limit use of blood thinners, aspirin, and ibuprofen.

PROGNOSIS

Hip pointer usually goes away within 2 weeks, with proper treatment.

RELATED COMPLICATIONS

  • Too much bleeding, leading to prolonged impairment.

  • Infection (uncommon).

  • Hip stiffness.

  • Delayed healing or resolution of symptoms, especially if activity is resumed too soon.

  • Inflammation of a sac between the bone and tendon (bursitis).

TREATMENT

Treatment first involves ice and medicine to reduce pain and inflammation. Heat, massage, and physical therapy should be delayed for about 48 hours after injury. Rest, and avoid further injury, to allow the tissue to heal. Physical therapy may be advised. This can be competed at home or with a therapist. Once you return to activity, you may want to add padding in the area, to prevent injury. On rare occasions, contusion will require surgery or aspiration (removal of fluids with a needle).

MEDICATION

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines (aspirin and ibuprofen), or other minor pain relievers (acetaminophen), are often advised.

  • Do not take pain medicine within 48 hours of injury or for 7 days before surgery.

  • Prescription pain relievers may be given. Use only as directed and only as much as you need.

  • Ointments applied to the skin may help.

  • Corticosteroid injections may be given to reduce inflammation, but are not common for this injury.

HEAT AND COLD

  • Cold treatment (icing) should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain, and immediately after activity that aggravates your symptoms. Use ice packs or an ice massage.

  • Heat treatment may be used before performing stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or a warm water soak.

SEEK MEDICAL CARE IF:

  • Symptoms get worse or do not improve in 2 weeks, despite treatment.

  • New, unexplained symptoms develop. (Drugs used in treatment may produce side effects.)