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Sonographic evolution of soft tissue hematomas over time
| Stage | Approximate timeframe | B-mode US appearance | Color Doppler findings |
|---|---|---|---|
| Acute | 0–48 hours | Anechoic or mildly hypoechoic; may show fine internal echoes from fresh clot; usually compressible; poorly defined margins in early phase | Absent internal flow; possible mild peripheral hyperemia due to surrounding inflammation |
| Early subacute | 3–7 days | Heterogeneous echotexture with internal echogenic sediment, fine septations, and possible fluid–fluid levels | No internal vascularity; peripheral hyperemia may persist |
| Late subacute | 1–3 weeks | Increasingly complex internal echoes; formation of thin capsule; partial organization of clot | Generally avascular internally; mild peripheral flow possible |
| Chronic/organized | >3–6 weeks | Well-defined margins; hypoechoic or mixed echogenicity with capsule; possible peripheral calcifications or echogenic septa | Absent internal flow; thin peripheral vascular rim may be reactive |