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Dr. R. Bora
Dr. R. Bora, Doctor
Category: Health
Satisfied Customers: 5229
Experience:  14 years experience in the emergency room.
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I have been experiencing bruising on my right shin for quite

Customer Question

I have been experiencing bruising on my right shin for quite some time now. The bruises usually appear at a rate of 5 - 10 at a time. I was recently admitted to hospital for a series of autonomic tests and I inquired to a specialist there about the bruising. She told me that it may be due to Ehlers-Danlos Syndrome as I suffer from hypermobile joints and suspected expanding blood vessels. However the symptom of EDS that she was referring to was 'easy bruising' and yet I barely bruise anywhere else on my body, even if I were to injure myself a bruise wouldn't appear.

I am currently in a wheelchair due to dystonia in my feet so I highly doubt any injury or strain. It's really upsetting me now because I'm starting to think that it may be something more serious. I also have patella subluxation that is untreated and pain throughout my leg and thigh which starts at the knee.
Submitted: 1 year ago.
Category: Health
Expert:  Dr. R. Bora replied 1 year ago.
Hello and welcome, I am happy to help you today.

Are the bruises assoiated with pain in the shin area?

Have you checkedy your platelet count?

Do you have dystonia in both feet?
Customer: replied 1 year ago.

The bruises are sensitive to touch, yes.

 

I have and there are no abnormalities.

 

Yes but more significant in my left foot yet my right leg is affected with the bruising.

Expert:  Dr. R. Bora replied 1 year ago.
Thanks for the additional info, Sophie.

The multiple shin bruising which has been occurring repeatedly could be due to superficial or deep vein thrombosis.You should get a doppler ultrasound study of the veins like the anterior tibial and peroneal veins in that area to diagnose venous thrombosis, which is a common condition associated with shin bruising.

Ehler Danlos could be another possibility and easy bruising is more common with the type IV / vascular type, although lesser amounts can occur with the others like the type III (hypermobility joint type).

The diagnosis of Ehlers-Danlos syndrome is based upon the clinical findings and the family history. For some types of Ehlers-Danlos syndrome, a skin biopsy to determine the chemical makeup of the connective tissue can help to suggest the diagnosis. So, I would suggest that you talk to you doctors and get tested for EDS.

One more possibility is blood coagulopathy.You should check your other blood parameters like factor 5 deficiency ,MCHC, MCH, red cell indices etc to exclude coagulopathy. You should consult a hematologist for this.Although you do not have easy bruising in other areas, the shin area is more susceptibe to injury and bruising, so mild coagulopathic disorder could be a possibility.



I hope my answer has helped you.


Please remember to rate my service positive once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!


If you have any further question, I would be happy to help you.
Expert:  Dr. R. Bora replied 1 year ago.
Von willebrand's disease is one coagulopathy that is very common and should be checked.
Customer: replied 1 year ago.

I just replied but I don't know if you received it.


 


I suffer from obscure blotching on both legs. The leg and feet turn a light purple and there are also red and white blotches. Could this be related to the vascular EDS and the bruising? If not then what is it?

Expert:  Dr. R. Bora replied 1 year ago.
I did not get any other reply, just this one.

As I said, you have to get checked for a few possibilities one after another considering your history of random blotching, so that you get the diagnosis. I will shortlist them for you.

1. EDS , vascular type.

2. Deep vein thrombosis: get a doppler ultrasound study for this.

3. Coagulopathy or bleeding disorders like Von willebrand's disease, the most common type of bleeding disease.

I hope my answer has helped you.


Please remember to rate my service positive once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!
Expert:  Dr. R. Bora replied 1 year ago.
Why have you given me a "poor service".

I did not receive your previous reply but do think that my answer is wrong that you gave me a negative rating?

Is there any thing that you want to know, l would be glad to help you.
Expert:  Dr. R. Bora replied 1 year ago.
hello sophie.

Could this be related to the vascular EDS and the bruising? If not then what is it?

The answer to this question is that vascular EDS is a strong possibility but you will have to get tests like skin biopsy to make sure you have EDS, since it is a connective tissue disorder.

Other possibility is factor VIII deficiency like Von Willebrand disease. This also needs specific tests like testing for like factor VIII .

Anything else you would like to know?
Customer: replied 1 year ago.

Who do I speak to in order to have the skin biopsy? The specialist said that I will have to have another EMG but a biopsy was never discussed.


 


I gave you a poor rating as I am still unclear as to why I am bruising. If it was due to thin tissue on the shin then why am I not bruising on my left leg, where the dystonia affects me more? It doesn't make sense as I am bed ridden and only use a wheelchair if I need to get around.


 


Please help me as I'm getting worried. My GP and Neurologists aren't listening to me.

Expert:  Dr. R. Bora replied 1 year ago.
Hello Sophie, thanks for getting back to m again.

1. For the skin biopsy, you should talk to your medicine MD. The skin biopsy along with the clinical examination will tell you if you are indeed having EDS.

2. The more frequent shin bruising on your right leg could be due to venous thrombosis, which I had mentioned in my previous reply. You would have to take anti thrombotics for prevent these bruising but you would have to exclude blood coagulopathy to take anti thrombotic medicines. You will have to talk to your medicine MD to know about this.


If you have any further question, I would be happy to help you.

I hope my answer has helped you.


Please remember to rate my service positive once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!

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