I am Dr Shamoon. From the history of a direct fall from a bike followed by a dark patch on the thigh in a 70-year-old man, what you are seeing is almost certainly a bruise (contusion/haematoma) - blood that has leaked out of small injured vessels into the tissue under the skin - and not a "blood clot" inside a vein, and not a skin allergy or rash. That distinction matters: a bruise from trauma is superficial and resolves on its own over 2-3 weeks, changing colour from red-purple to blue-black, then greenish-yellow-brown as it clears. An allergic rash would be itchy, raised, more widespread and would not be confined to the impact site. The genuinely important issue at his age is what else the fall may have caused, and whether a bruise is expanding. A localised firm, tender, swollen lump means a haematoma that is collecting, and in an elderly person a thigh injury can also fracture the femur or cause deep muscle bleeding with significant blood loss - so pain on weight bearing, inability to walk, or a deformed/shortened limb must be checked with an X-ray. Also, if he takes aspirin, clopidogrel, warfarin or any blood thinner, or has
liver disease or a low platelet count, bruising is larger and continues longer, and he needs a doctor's review rather than home care. A true deep vein thrombosis presents differently - diffuse calf or whole-leg swelling, tightness and warmth rather than a patch - and would need an urgent Doppler scan.
Next Steps
1) Get him examined in person and get an X-ray of the thigh/hip if he has pain on walking, difficulty bearing weight, or tenderness over the bone - a fall at 70 must not be assumed to be only a bruise. 2) For the bruise itself: cold compress for 15 minutes 3-4 times a day for the first 48 hours after injury; after 48 hours switch to warm compresses to speed up clearing. Keep the leg elevated when resting. 3) Paracetamol 500-650 mg is the safest painkiller here; avoid ibuprofen, diclofenac and aspirin-type painkillers as they increase bleeding into the bruise and can affect the kidneys at his age. 4) Do not massage the area, apply no strong balms, and do not attempt to needle or drain it. 5) Encourage gentle ankle and knee movement and short walks as tolerated to prevent stiffness and reduce clot risk from immobility. 6) Tell the doctor about every medicine he takes, especially any blood thinner, and get a CBC with platelet count, PT/INR and
creatinine if he is on one. 7) Measure the patch (or photograph it daily against a ruler) - it should stay the same size or shrink; expansion needs same-day review. 8) An ultrasound/Doppler of the leg is indicated if the whole limb swells, or the calf becomes tight, warm and painful. 9) Also review the reason for the fall - vision, blood pressure, balance,
sugar levels - to prevent the next one. You are welcome to consult me on Practo with the photo and his medicine list, or in person at Synergy Multispeciality Hospital, Miraj.
Health Tips
Word of caution: get emergency care if the thigh becomes rapidly swollen, tense and severely painful, if the skin turns pale, cold, numb or blackish, if he cannot move or bear weight on the leg, if there is fever with increasing redness and pus, or if he becomes giddy, breathless, has chest pain or a fast pulse - internal bleeding and clot travelling to the lungs are the two serious risks after such a fall. Do not massage the area or take ibuprofen/aspirin-type painkillers.