Answer for BIR CoW 13 Sep 2020
Morel -Lavallee Lesion
Findings
Non-contrast axial computed tomography (CT) image of the right thigh shows an ovoid hyper-dense lesion in the deep subcutaneous plane abutting the deep fascia at the level of greater trochanter. Note is also made on extensive subcutaneous edema. Post contrast coronal CT image shows no enhancement or no active contrast extravasation with in the lesion.
Discussion
Morel-Lavallée lesion is a type of closed degloving injury. It is usually associated with severe trauma. Clinically present as a hemolymphatic mass following trauma. It is classically seen over the greater trochanter of femur. It occurs when the skin and subcutaneous tissue abruptly separate from the underlying fascia. The initial injury represents a shearing of subcutaneous tissues away from underlying fascia resulting in accumulation of various types of fluid, ranging from serous fluid to frank blood. Ultrasound, CT and MRI are used for evaluation of these lesions. The diagnosis is straightforward in the correct clinical setting. Sometimes, patient may present late and the chronic lesions may cause a diagnostic dilemma. Evacuation of the haematoma and the necrotic material is the preferred treatment.
Findings
Non-contrast axial computed tomography (CT) image of the right thigh shows an ovoid hyper-dense lesion in the deep subcutaneous plane abutting the deep fascia at the level of greater trochanter. Note is also made on extensive subcutaneous edema. Post contrast coronal CT image shows no enhancement or no active contrast extravasation with in the lesion.
Discussion
Morel-Lavallée lesion is a type of closed degloving injury. It is usually associated with severe trauma. Clinically present as a hemolymphatic mass following trauma. It is classically seen over the greater trochanter of femur. It occurs when the skin and subcutaneous tissue abruptly separate from the underlying fascia. The initial injury represents a shearing of subcutaneous tissues away from underlying fascia resulting in accumulation of various types of fluid, ranging from serous fluid to frank blood. Ultrasound, CT and MRI are used for evaluation of these lesions. The diagnosis is straightforward in the correct clinical setting. Sometimes, patient may present late and the chronic lesions may cause a diagnostic dilemma. Evacuation of the haematoma and the necrotic material is the preferred treatment.
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!