Inner Thigh Bruising After Hip Fall: Normal Finding
Yes, inner thigh bruising is a normal consequence of a fall on the hip and represents soft tissue injury from direct trauma or blood tracking along fascial planes from the impact site.
Mechanism and Expected Findings
Inner thigh bruising after a hip fall occurs through two primary mechanisms:
- Direct soft tissue trauma from the impact causes muscle contusion and bleeding within the thigh musculature 1
- Blood tracking along fascial planes allows hematoma to spread from the hip impact site to adjacent areas including the inner thigh 2
The bruising pattern reflects the dissipation of energy through soft tissues surrounding the hip joint, which commonly extends to adjacent anatomical regions 3.
Clinical Significance and Red Flags
While bruising itself is expected, the key concern is excluding underlying hip fracture, which is the primary morbidity and mortality risk:
- Hip fractures occur in approximately 300,000 patients annually following ground-level falls, with a 1-year mortality rate of 22% in women and 33% in men 4
- Physical examination findings suggesting fracture include inability to bear weight, groin pain, external rotation, abduction, and leg shortening 5
- Bruising alone does not indicate fracture, but persistent pain with inability to ambulate warrants imaging 5
Diagnostic Approach
Obtain plain radiographs (AP pelvis and cross-table lateral hip views) if the patient has groin pain or cannot bear weight, regardless of bruising pattern 4:
- Radiographs are the initial imaging modality of choice for suspected hip fracture 4
- If radiographs are negative but clinical suspicion remains high, MRI should be ordered to exclude occult fracture 5
- Delays in fracture diagnosis increase complications, hospital stay, and mortality 4
Important Caveats
Rhabdomyolysis risk: If the patient was immobilized after falling and unable to call for help, check electrolytes—hyperkalaemia may indicate rhabdomyolysis 4.
Age considerations: In elderly osteoporotic patients, even minor falls can cause fractures, making imaging more critical 4, 5.
The bruising itself requires no specific treatment beyond standard soft tissue injury management (rest, ice, compression, elevation), but the underlying hip must be evaluated to exclude fracture 1.