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Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 4947
Experience:  Experience of Neurology of over 4 years, well versed in EEG, NCS and EMG alongwith MRIs and CT scans
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My dad fell a week ago on s buttock...............buttock is

Customer Question

my dad fell a week ago on his buttock...............buttock is swollen and now swelling has gone right down his thigh and ankle thigh very swollen
is this a concern that he is retaining fluid or is it just the natural progression of the injury./....he fell on his right side so hip is also sore......xray showed no break\
thank you so much
Submitted: 9 months ago.
Category: Neurology
Expert:  Dr. Muneeb Ali replied 9 months ago.

Hi,

Im sorry to hear about your dad. Can i ask does he have any other medical conditions or is he taking any medications? Is there bruising over the area?

Expert:  Dr. Muneeb Ali replied 9 months ago.

Since you seem to be offline, ill leave a response here which we can discuss later on.

Now this sort of swelling following trauma can be very concerning especially if there is overlying bruising in the area. The first thing which comes to mind is that he could have damaged a vessel in the area which is bleeding and causing the swelling in the area. This would also cause bruising in the area and would be more likely if he was on blood thinning medication of any sort like warfarin or aspirin. If there is bruising then you should DEFINITELY contact urgent care and have this evaluated. This would be diagnosed on a clinical examination and maybe even a MRI.

Another cause of this can be associated with the lymphatic system of the leg. It is possible that there may be damage to the lymph vessels. If this is the case then there could be swelling which may be diagnosed on the basis of a clinical examination And in most cases this would be treated with compression stockings etc.

Now the most concerning possibility is that he could have developed a clot in the leg. This is a distinct possibility after injuries of this sort. If this is the case then he would have swelling, raised temperature over the area and sometimes even pain. The diagnosis would have to be made with the help of an immediate doppler USG and then treated with blood thinning medications.

There is a possibility that this is only fluid retention and not any of the other conditions which i mentioned, but considering the risk of a blood clot i would STRONGLY recommend that you have this evaluated at urgent care with atleast a doppler ultrasound of the leg. If this is a clot then early treatment is recommended.

Do you have any more questions?

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Customer: replied 9 months ago.
hello ....... my dad has prostrate cancer metastized to left bone .......
he is on cumadin for a-fib
he takes bp meds
he has one kidney which functions at 30 %he fell on his right side last thursday and by saturday he was in such pain he called 911 to go to emerg. bloodwork and xray done. nothing broken............sent home with pain meds.i arrived sunday and his buttock black and blue and swollen.
monday he had swelling in right foot and ankle
following few days his bruising has gone down his leg and his thigh is very swollen today.he is not in tremendous pain unless he tries to get in and out of his chairshould i be concerned about a possible clot or is it normal to have the swelling and bruising refer down his leg>
Expert:  Dr. Muneeb Ali replied 9 months ago.

He needs to go to urgent care, the bruising indicates that he is continuing to bleed inside the tissues. This is because of the warfarin which he is on, secondly if he continues to bleed like this it will cause the leg to become tense and when that happens, he can develop compartment syndrome which in turn can cause the pressure to rise so much that the leg can develop gangrene.

The clot was a possibility when i didnt know he was on warfarin and that he had bruising, the bruising CLEARLY indicates he is actively bleeding and you NEED to take him to the ER or urgent care ASAP. The fact that the swelling is increasing even if the bruising has gone down means that there is something wrong in the area. This could be early compartment syndrome setting in. He will need a doppler ultrasound alongwith a normal ultrasound to determine the cause of this. But in short, DO take him to the ER or urgent care center and have this evaluated.

Do you have any more questions?

Please leave a POSITIVE (3 – 5 stars,preferably 5) rating by clicking on the stars above, until you do i am notcompensated for my time. You cancontinue to ask follow-up questions even after the POSITIVE rating. You canalso ask questions from me directly by going on the link below,

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Expert:  Dr. Muneeb Ali replied 9 months ago.

One more thing is that considering his pre existing decreased renal function, this swelling and bleeding into the tissues can further compromise his renal function. This would be evident with a decreased urine output, he could be passing a lesser amount of urine than usual. That is another reason for him to be evaluated at urgent care or the ER.

Please leave a POSITIVE (3 – 5 stars,preferably 5) rating by clicking on the stars above, until you do i am notcompensated for my time. You cancontinue to ask follow-up questions even after the POSITIVE rating. You canalso ask questions from me directly by going on the link below,

http://www.justanswer.com/medical/expert-dr-muneeb-ali/