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Bone bruises fall on the fracture spectrum and are so named because of the dark spot they create on MRI. The ends of long bones—such as the femur of the thigh and the tibia and fibula of the lower leg—are comprised of cancellous bone, which is relatively porous and filled with blood. When a small portion of the spiderweb-like matrix inside the cancellous bone fractures, a dark image appears on MRI and is diagnosed as a bone bruise.
Like most fractures, bone bruises typically heal within a matter of weeks, and rarely do they progress to a more severe injury. As such, the primary factor when determining a return-to-play is the amount of pain the athlete is experiencing, as well as their ability to tolerate said pain.
According to Baseball Prospectus’s Recovery Dashboard, three MLB players have suffered a bone bruise in their knee since 2017, with the median number of days missed settling in at 27. The median days missed jumps to 28 when considering bone bruises in general, regardless of body region.
The Twins will continue to assess Lewis’s knee in the coming days as the swelling decreases and the holiday weekend comes to a close. But for now, it would appear as if he—and the Twins—dodged a major bullet.
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