Morel- Lavallee Lesion

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Morel- Lavallee Lesion

Authors, Editors, Case Information Author: Kathy Vidlock, MD Affiliation: Rocky Vista University Co Author(s): none Senior Editor: Carlton Covey, MD, MEd Clinical Vignette: 38 yo female runner with diffuse hip pain for 3 days. She fell on mile 10 of a 50 mile race and slid along the trail. She had immediate onset pain, and noted swelling thereafter. Exam showed visible swelling and an abrasion; full ROM and strength of the hip were noted. Type of Probe Used: L12-3 MHz #1 - Image This image is in long axis of the lateral hip and shows the anechoic area between the subcutaneous tissue/superficial fascial layer and the deep fascia/muscular layer. #2 - Image This labeled image is in long axis of the lateral hip and shows the anechoic area between the subcutaneous tissue/superficial fascial layer and the deep fascia/muscular layer. #3 - Image This image is in short axis of the lateral hip and shows the anechoic area between the subcutaneous tissue/superficial fascial layer and the deep fascia/muscular layer. #4 - Image This labeled image is in short axis of the lateral hip and shows the anechoic area between the subcutaneous tissue/superficial fascial layer and the deep fascia/muscular layer. #5 - Image This image in short axis shows measurement of the Morel Lavallee lesion. Unfortunately the lesion was too long for us to measure accurately in short axis with one image. Interpretation Image Interpretation: There is an anechoic area between the superficial and deep fascial layers over the lateral hip. The largest area is measured in the last image but the whole lesion was too big for our machine to adequately measure. Teaching Pearl: A Morel-Lavellee lesion is a closed, traumatic soft tissue degloving injury, characterized by a shearing injury of subcutaneous tissues away from underlying fascia/muscles along interfascial planes. The initial potential space created superficial to the fascia is filled with various types of fluid, ranging from serous fluid to frank blood. The most common location is over the greater trochanter but can occur in other areas of the body. MRI is considered the gold standard for diagnosis, but sports US is a fast, cheap and effective alternative. Conservative treatment including compression and early ROM may be helpful. If conservative measures fail sclerodesis, aspiration, or surgical drainage may be considered.
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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Authors, Editors, Case Information

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Interpretation

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