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  1. J D Perry
  1. London

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    See also page 122.

    Bleeding problems presenting as a result of sporting injury are rare. They are either congenital or acquired and most congenital problems present in early childhood when toddlers begin to walk and fall over. There are, however, some disorders that are milder and which may only cause haematoma as a result of more severe injury; von Willebrand's disease is the commonest of these. There are also a number of hereditary platelet problems that may present with easy bruising and may require specialist referral for diagnosis. Most cases of easy bruising are not associated with any haematological abnormality. A bleeding time is a useful means of assessing such patients, but a detailed history, including family history, and aclinical examination, are prerequisite and are best undertaken by a specialist. Asprin and other non-steroidal anti-inflammatory drugs can lead to easy bruising in normal people. Thrombocytopenia is a fairly common condition, usually transient, which can cause easy bruising and infectious mononucleosis, and can occasionally result in severe thrombocytopenia, and splenic rupture as a result of playing rugby while convalescing from infectious mononucleosis has occurred.

    Other coagulation problems fortunately are rare and usually associated with such severe illnesses that the patient would be too unwell to participate in sport.

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