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What Does An Unexplained Bruise Behind The Knee Of An Elderly Person Indicate?

Posted on Mon, 4 Jul 2016

Question: Dear Doctor, my elderly aunty who is essentially mute and has been immobile for 3 months and is on NO medications. please view a photo I have taken this photo..a red bruise or red skin has appeared below and behind the knee. Does this mean anything of sinister meaning..She had NOT incurred any falls or any hit in this area it just appeared overnight...Please help as I am concerned.

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
maybe due to fragile capillaries

Detailed Answer:
Hi
Thanks for your query.

You have mentioned about her being elderly but have put the age as 55 years. Have you put your age by mistake?

In elderly persons, the skin capillaries become fragile. So even trivial trauma can cause bruises. Most probably it is that only.

If this recurs frequently, then I would recommend a complete blood count and coagulation profile.

Hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (32 hours later)

Thank you Dr XXXXXXX my concern her is Deep venous thrombosis...due to immobility. I have been told that bruising below and under the knee is a initial sign of DVT..I checked her inr and pptime they are normal please advise if you require the results however as NO medications are being taken except for antibiotics due to occasional UTI'S..what can I do.

Answered by Dr. Indranil Ghosh (2 hours later)

Brief Answer:
bruise and DVT are separate

Detailed Answer:
Thanks for follow up.

Bruise is due to bleeding under skin while DVT is clot inside veins located under muscle. Bruise is not a feature of DVT. But in DVT there can be swelling with redness of skin, which may look like bruise.

If DVT is a suspicion, we need to a Doppler of leg veins. It is a noninvasive test. INR or other blood tests will not help.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (33 hours later)

Thank you Doctor, Is there any blood tests to suggest or indicate that there are blood clots in the veins , arteries or capillaries..kind regards.

Answered by Dr. Indranil Ghosh (4 hours later)

Brief Answer:
there are but not very specific

Detailed Answer:
Serum D-dimer, if high can suggest clotting inside veins but it is not very specific. Which means that not 100% cases with high d-dimer will have clots.

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar