This patient has a quadriceps contusion. Acute management includes cold compression and immobilization in flexion. Surveillance for compartment syndrome is needed acutely and chronic manifestations include myositis ossificans. Iliac crest contusions or “hip pointers” occur after direct trauma and benefit from placing the affected leg in extension. Athletic pubalgia or “sports hernia” is an injury to the muscles of the abdominal wall or adductor longus that produces anterior pelvis and groin pain in the absence of a true inguinal hernia. The references by Ryan et al and Aronen et al are Level 4 studies of soldiers sustaining quadriceps contusions treated with hyperflexion of the knee and cold compresses. The average time of disability was 3-13 days between the 2 studies. There was a 5% and 9% rate of myositis ossificans, respectively. Illustration A depicts the position of immobilization for quadriceps contusion treatment.
Ryan JB, Wheeler JH, Hopkinson WJ, Arciero RA, Kolakowski KR. Quadriceps contusions. West Point update. Am J Sports Med. 1991 May-Jun;19(3):299-304.
PMID:1867338 (Link to Abstract)
Aronen JG, Garrick JG, Chronister RD, McDevitt ER. Quadriceps contusions: clinical results of immediate immobilization in 120 degrees of knee flexion. Clin J Sport Med. 2006 Sep;16(5):383-7.
PMID:17016112 (Link to Abstract)