A hematoma is a localized collection of blood that accumulates outside of blood vessels, often resulting from injury or trauma. When this pooled blood hardens due to the deposition of calcium salts, it forms a calcified hematoma. This process transforms a fluid-filled bruise into a firm, sometimes palpable, mass.
Understanding Calcified Hematomas
The body typically initiates a process to reabsorb pooled blood over time. However, in some instances, this reabsorption is incomplete or ineffective, leading to the hardening of the hematoma. This hardening, known as dystrophic calcification, involves the deposition of calcium within the soft tissue where the blood initially collected.
Calcified hematomas can develop in various parts of the body. They are common in areas prone to repeated impact or trauma, such as muscles. They can also occur in subcutaneous tissue (under the skin), and within organs. The process of calcification can take several months after the initial hematoma forms.
Natural Course and Resolution
While many hematomas resolve on their own, calcified hematomas are less likely to disappear completely due to their hardened nature. Factors such as the size of the hematoma, its location, and the extent of calcification influence the likelihood of any natural resolution. Smaller calcium deposits might be reabsorbed over time, but larger or more extensively calcified masses typically persist.
Complete spontaneous resolution of the calcified portion is uncommon. However, while the physical mass may remain, associated symptoms might lessen over time as the initial inflammation subsides. The body’s inability to fully reabsorb the pooled blood, potentially combined with poor circulation or repeated trauma, contributes to this calcification process. This hardened tissue can also be referred to as fibrotic or ossified tissue, indicating a transformation into a more permanent structure.
Symptoms and Medical Consultation
Calcified hematomas can present with various symptoms depending on their size and location. A common symptom is a palpable lump or mass under the skin, which may be firm or tender to the touch. If the calcified hematoma is in a muscle, it might cause localized pain or restrict movement, especially during physical activity.
Many calcified hematomas remain asymptomatic, particularly if they are small and do not press on surrounding structures. However, problems can arise if the mass grows or is situated where it compresses nerves, blood vessels, or interferes with organ function. For example, a calcified hematoma in the brain can lead to headaches, confusion, weakness, or seizures. Medical consultation is recommended if there is persistent pain, increasing size of the lump, new neurological symptoms, or any concerns about the nature of the mass.
Treatment Approaches
Asymptomatic calcified hematomas often do not require active treatment and may simply be monitored. For those that cause problems, treatment approaches vary based on the symptoms and the hematoma’s characteristics. Conservative management options may include pain relief medications and physical therapy. Physical therapy can involve techniques like manual therapy to improve circulation and tissue pliability, therapeutic ultrasound to help break down deposits, and targeted exercises to restore range of motion and strength.
When conservative methods are insufficient or symptoms are severe and persistent, surgical removal is considered the primary definitive treatment option. Considerations for surgery include the hematoma’s size, its location, and the potential risks associated with the procedure, especially if it adheres to sensitive structures. In some cases, calcified hematomas can integrate with underlying bone or cartilage, making surgical removal more complex.