Anticoagulant-related intramuscular hematomas are uncommon. However, when they do occur, the clinical consequences can be significant. The authors describe nine patients on anticoagulation undergoing rehabilitation who experienced an intramuscular hematoma. In all cases, activity in therapy before the intramuscular hematoma was considered normal therapeutic activity and consistent with activity commonly performed during rehabilitation. The study found that the anticoagulated rehabilitation population is at risk for intramuscular hematomas and poses a diagnostic challenge because many are insensate and, therefore, present atypically.
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