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What Causes Recurring Bruises On Calf And Knee?
Question: I have recurring bruises on my right calf under my knee. they are tender to touch and usually spread over a week or so to a small trail of dark purple bruises. and having blurry vision in one eye, slight numbness in legs & lower back pain. not sure if all are related but seem to happen all together. my cholesterol has been kind of high so worried it might be related. any idea what this might be? no one seems to be able to answer for me.
Brief Answer:
Vasculitis or herpes needs evaluation
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Jyothi BL and I will be answering your query.
After going through the clinical history and query, my opinion is as follows:
1. Recurring bruises on the right calf without injury, requires evaluation of clotting disorder. Superficial bruises are usually less painful unless it is vasculitis.
2. If you are not sure about the bruises, an image will be helpful. As it is related to a single spot (dermatomal distribution) and is painful, an evaluation of shingles also needs to be ruled out.
You need to get evaluated for Herpes and vasculitis.
Vasculitis can cause multiple symptoms affecting nerves and eyes. It might require a blood vessel biopsy.
Herpes can also present with neural manifestations. Reactivation can present with shingles.
Meet you doctor and discuss about the investigations. Shingles needs to be treated at the earliest as it could present with severe neuropathic pain. You will require to be started on anti-virals at the earliest.
If it is bruises only, then investigation of platelet count, bleeding time, prothrombin time and partial thromboplastin time is required to rule out any bleeding or clotting disorders.
Meet your doctor for investigations.
Any further queries, happy to help again.
Dr. Jyothi BL
Vasculitis or herpes needs evaluation
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Jyothi BL and I will be answering your query.
After going through the clinical history and query, my opinion is as follows:
1. Recurring bruises on the right calf without injury, requires evaluation of clotting disorder. Superficial bruises are usually less painful unless it is vasculitis.
2. If you are not sure about the bruises, an image will be helpful. As it is related to a single spot (dermatomal distribution) and is painful, an evaluation of shingles also needs to be ruled out.
You need to get evaluated for Herpes and vasculitis.
Vasculitis can cause multiple symptoms affecting nerves and eyes. It might require a blood vessel biopsy.
Herpes can also present with neural manifestations. Reactivation can present with shingles.
Meet you doctor and discuss about the investigations. Shingles needs to be treated at the earliest as it could present with severe neuropathic pain. You will require to be started on anti-virals at the earliest.
If it is bruises only, then investigation of platelet count, bleeding time, prothrombin time and partial thromboplastin time is required to rule out any bleeding or clotting disorders.
Meet your doctor for investigations.
Any further queries, happy to help again.
Dr. Jyothi BL
Above answer was peer-reviewed by :
Dr. Prasad
thank you very much for your response. I uploaded two photos of my bruises. the first photo was the beginning of September. it stayed for a couple of weeks & that was at it's worst. no bruise was present for a few weeks. and now I have another bruise forming that keeps getting darker and sore to touch. what does this look like to you?
Brief Answer:
Require coagulation profile
Detailed Answer:
Hi,
Thanks for asking again.
I went through the images.
It does not appear to be shingles. Shingles will initially start as vesicles and then rupture.
You need to get a coagulation profile workup to rule out any bleeding/clotting disorders.
Also check for the possible cause. Any itching reactions, or tight cloth rubbing or specific position while sitting, which could exacerbate it.
Further evaluation for vasculitis and coagulation profile is essential. Do get the tests done, if you cannot think of possible cause.
For vasculitis, blood vessel biopsy is essential.
Discuss with your doctor to get a coagulation profile estimated.
How did it disappear previously? Any medications were applied? Next time you correspond with more details, do let know about your medications and if possible attach hematological reports and any other reports you get.
Any further queries, happy to help again.
Dr. Jyothi BL
Require coagulation profile
Detailed Answer:
Hi,
Thanks for asking again.
I went through the images.
It does not appear to be shingles. Shingles will initially start as vesicles and then rupture.
You need to get a coagulation profile workup to rule out any bleeding/clotting disorders.
Also check for the possible cause. Any itching reactions, or tight cloth rubbing or specific position while sitting, which could exacerbate it.
Further evaluation for vasculitis and coagulation profile is essential. Do get the tests done, if you cannot think of possible cause.
For vasculitis, blood vessel biopsy is essential.
Discuss with your doctor to get a coagulation profile estimated.
How did it disappear previously? Any medications were applied? Next time you correspond with more details, do let know about your medications and if possible attach hematological reports and any other reports you get.
Any further queries, happy to help again.
Dr. Jyothi BL
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
i just went to my doctor and they kind of brushed me off about the bruising as if it was nothing. they do that a lot but to me, i know my body and something doesnt feel right. those bruises went away on their own before after about 2 weeks. just saw it start to come back about 5 days ago so I made an appointment to check it out. i attached a report i got done in May to test for a bunch of things and the thing i wasnt sure of was rhe Peripheral Arterial Disease test being inconclusive on the right side. my right leg is the one thats getting bruises. at my appointment yesterday they also checked a spot on my back that they are sending me to get a biopsy on, i asked about it because ive gone tanning and never really checked my skin. not sure if any of this is related but figured i would put it out there. my right hand feels like the joints are a little sore as well. everything just feels off and its been very difficult to get an answer. for medications i take Gabapenton (for these physical symptoms of numbness in legs and headaches etc.. not really helping anymore though) also take multivitamins, fish oil, b12, biotin, vitamin d & e, probiotics. also, could any of this be part of a bacterial infection? hope this all helps
Brief Answer:
Its not peripheral arterial disease
Detailed Answer:
Hi,
Thanks for asking again.
I went through the report.
Inconclusive on the right side indicates higher pressure more than normal.
It goes against the possibility of any obstruction leading onto ischemic pain on the right side.
Now, on the back, I suspect they are possibly looking at neural causes like compression of nerve supplying the right leg in between the vertebrae (lumbar spondylosis). Neural compression can also cause pain. X-ray or MRI would reveal any reduction in vertebral space.
Ganapentin is usually prescribed either for epilepsy or neuropathic pain. You can ask your doctor to taper it, if its not useful. Numerous neural adverse effects are present due to it. It can increase headaches, dizziness, parasthesia, dipolopia, vomiting etc. Do discuss with your doctor regarding it. Do not discontinue on your own.
If its not peripheral arterial disease, neural compression can be thought of.
However, if bruises repeats again at same spot, local causes of dressing, abnormal sitting etc requires evaluation. If it repeats at other spots, Coagulation workup is essential.
Relaxation, nutritional diet and moderate exercises are essential. You are on enough medication.
Probiotics are only for the gut. Bacterial infection would have been severe (septicemia) with high grade fever, extreme fatigue, etc. None of the manifestation are bacterial infection including bruises.
Meet an ophthalmologist to check your vision problem. Cause needs to be identified. It might be helpful.
Hope it helps.
Any further queries, happy to help again.
Dr. Jyothi BL
Its not peripheral arterial disease
Detailed Answer:
Hi,
Thanks for asking again.
I went through the report.
Inconclusive on the right side indicates higher pressure more than normal.
It goes against the possibility of any obstruction leading onto ischemic pain on the right side.
Now, on the back, I suspect they are possibly looking at neural causes like compression of nerve supplying the right leg in between the vertebrae (lumbar spondylosis). Neural compression can also cause pain. X-ray or MRI would reveal any reduction in vertebral space.
Ganapentin is usually prescribed either for epilepsy or neuropathic pain. You can ask your doctor to taper it, if its not useful. Numerous neural adverse effects are present due to it. It can increase headaches, dizziness, parasthesia, dipolopia, vomiting etc. Do discuss with your doctor regarding it. Do not discontinue on your own.
If its not peripheral arterial disease, neural compression can be thought of.
However, if bruises repeats again at same spot, local causes of dressing, abnormal sitting etc requires evaluation. If it repeats at other spots, Coagulation workup is essential.
Relaxation, nutritional diet and moderate exercises are essential. You are on enough medication.
Probiotics are only for the gut. Bacterial infection would have been severe (septicemia) with high grade fever, extreme fatigue, etc. None of the manifestation are bacterial infection including bruises.
Meet an ophthalmologist to check your vision problem. Cause needs to be identified. It might be helpful.
Hope it helps.
Any further queries, happy to help again.
Dr. Jyothi BL
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
i did get my eyes checked and they told me everything looked fine. I got an MRI in XXXXXXX and it came back normal. I dont know why I am on Gabapenton i feel like it has nothing to do with whats going on. Im worried about blood clots it makes me nervous. How can I get my doctor to give me these tests? What can I say? They always seem to brush me off like instead of beinf proactive. But I know something is not right. Even right now my whole body has a weird sensation. They always assume it is anxiety and maybe it is but theres something behind it. The bruising worries me .
Brief Answer:
Need to wait for another lesion.
Detailed Answer:
Hi,
Thanks for asking again.
You need to impress on your doctor, that you wont be taking gabapenton. It would not serve any purpose taking a medication, which will not help you solve your problems.
Gabpentine does not affect coagulation profile.
You can wait and watch for the next time, the lesion occurs in other areas. Same area, as I told you earlier - scratching for itching, rubbing of dress or abnormal position would be responsible.
If it does develop at other areas, then only it will be more collaborative and easy to tell you doctor about the requirement for coagulation profile.
Try to control your cholesterol. Even though, at present every blood vessel maybe alright based on your peripheral arterial disease test, future risk is present.
Look into anemia. I am not sure about your hemoglobin. See that it is within normal limits.
Good nutrition, regular sleep, avoiding stress and moderate exercises will be beneficial.
Discuss with your doctor about Gabapentin removal from your list of medications.
Hope it helps.
Any further queries, happy to help again.
Dr. Jyothi BL
Need to wait for another lesion.
Detailed Answer:
Hi,
Thanks for asking again.
You need to impress on your doctor, that you wont be taking gabapenton. It would not serve any purpose taking a medication, which will not help you solve your problems.
Gabpentine does not affect coagulation profile.
You can wait and watch for the next time, the lesion occurs in other areas. Same area, as I told you earlier - scratching for itching, rubbing of dress or abnormal position would be responsible.
If it does develop at other areas, then only it will be more collaborative and easy to tell you doctor about the requirement for coagulation profile.
Try to control your cholesterol. Even though, at present every blood vessel maybe alright based on your peripheral arterial disease test, future risk is present.
Look into anemia. I am not sure about your hemoglobin. See that it is within normal limits.
Good nutrition, regular sleep, avoiding stress and moderate exercises will be beneficial.
Discuss with your doctor about Gabapentin removal from your list of medications.
Hope it helps.
Any further queries, happy to help again.
Dr. Jyothi BL
Above answer was peer-reviewed by :
Dr. Yogesh D
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