Answer for CoW 13 November 2016
Posttraumatic seroma-left gluteal region
Findings
USG :Multiple heterogenous lesions with internal echoes and septations noted in subcutaneous plane over left gluteal region. MRI:T1,T2/FLAIR Large heterogenous multiloculated lesion measuring 8.8*8.1*12.7cm noted in subcutaneous plane at left gluteal region near greater trochanter of left femur. The lesion shows patchy areas of diffusion restriction with areas off blooming foci.
Discussion
Seromas are collections of serous fluid that usually occur as a complication of surgery, but can also be seen post-trauma.A Morel-Lavallée lesion represents a closed degloving injury associated with severe trauma which then presents as a haemolymphatic mass. MRI and ultrasound are useful modalities for evaluation.The lesions classically occur over the greater trochanter of the femur. USG: Typically these lesions are anechoic or hypoechoic; however, internal debris, including fat globules can give rise to echogenic foci or even fluid-fluid levels 1. A capsule of variable thickness may be seen. MRI is able to clearly determine the relationship of the collection with the underlying fascia. The fluid is of variable signal intensity depending on makeup and may even show a fluid-fluid level.
Findings
USG :Multiple heterogenous lesions with internal echoes and septations noted in subcutaneous plane over left gluteal region. MRI:T1,T2/FLAIR Large heterogenous multiloculated lesion measuring 8.8*8.1*12.7cm noted in subcutaneous plane at left gluteal region near greater trochanter of left femur. The lesion shows patchy areas of diffusion restriction with areas off blooming foci.
Discussion
Seromas are collections of serous fluid that usually occur as a complication of surgery, but can also be seen post-trauma.A Morel-Lavallée lesion represents a closed degloving injury associated with severe trauma which then presents as a haemolymphatic mass. MRI and ultrasound are useful modalities for evaluation.The lesions classically occur over the greater trochanter of the femur. USG: Typically these lesions are anechoic or hypoechoic; however, internal debris, including fat globules can give rise to echogenic foci or even fluid-fluid levels 1. A capsule of variable thickness may be seen. MRI is able to clearly determine the relationship of the collection with the underlying fascia. The fluid is of variable signal intensity depending on makeup and may even show a fluid-fluid level.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
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Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!