Bruising

Last updated: Monday, 26, July, 2010
CausesAppropriate Tests

Bruising is usually due to trauma and investigation should only be considered if the degree of bruising is disproportionate to the trauma.

Exclude use of aspirin, other NSAID: Where indicated, initial full blood count, PT/INR, APTT. If these are normal, and there is a low prior probability of underlying bleeding diathesis, no further investigation may be required.

Where von Willebrand disease is suspected, specific testing is required. In selected cases, other coagulation studies, with assays of specific coagulation factors and platelet function studies may be indicated.

See Bleeding Disorders.

Unrecognised trauma, especially 

  • Child abuse

Simple easy bruising

Easy bruising is common, particularly in females.

Skin 'fragility', due to

Clinical diagnosis.
  • Elderly patients
Easy and extensive superficial bruising ('senile purpura') is common in the elderly and in those who have experienced prolonged, excessive solar exposure - investigation is inappropriate.
  • Solar skin exposure
  • Cushing's syndrome, including prolonged corticosteroid therapy
  • Scurvy