A GP guide to haematomas of the thigh

With a variety of options available for investigation and management, this relatively common sports injury often has a favourable outcome.

Need to know:

  • Most thigh haematomas can be managed conservatively with the RICE principle.
  • Early (day 7-12) ultrasound-guided aspiration of moderate to severe intramuscular haematomas reduces the risk of delayed recovery and/or need for surgical intervention.
  • Consider referral for potential surgical evacuation of moderate to severe intramuscular haematomas that are not responding to conservative treatment or aspiration after two weeks.
  • Ultrasonography is the first-line imaging modality to assess small (<5cm) superficial haematomas.
  • Magnetic resonance imaging is preferred for larger or deeper lesions.
  • Always consider the possibility of associated compartment syndrome and unrelated causes of thigh swelling, such as sarcoma.

Haematomas caused by sport trauma require careful clinical evaluation and timely treatment in order to ensure a good