Morel-Lavallée lesion: Difference between revisions
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==Background== | ==Background== | ||
*Posttraumatic, closed degloving injury | *Posttraumatic, closed [[degloving injury]]<ref>Nair AV, Nazar P, Sekhar R, Ramachandran P, Moorthy S. Morel-Lavallée lesion: A closed degloving injury that requires real attention. The Indian Journal of Radiology & Imaging. 2014;24(3):288-290. doi:10.4103/0971-3026.137053.</ref> | ||
*Results in subcutaneous fluid collection after abrupt separation of skin and subcutaneous tissues from underlying fascia | *Results in subcutaneous fluid collection after abrupt separation of skin and subcutaneous tissues from underlying fascia<ref>J Emerg Med. 2015 Jul;49(1):e1-4. doi: 10.1016/j.jemermed.2014.12.084. Epub 2015 Apr 2.</ref> | ||
**Disrupts capillaries and lymphatics resulting in leakage of lymph, blood, and necrotic fat | **Disrupts capillaries and lymphatics resulting in leakage of lymph, blood, and necrotic fat | ||
*Most commonly seen in proximal thigh or overlying hip | *Most commonly seen in proximal thigh or overlying hip | ||
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*Enlarging, painful area of swelling | *Enlarging, painful area of swelling | ||
*Soft tissue fluctuance | *Soft tissue fluctuance | ||
*Associated with blunt trauma with or without associated fracture | *Associated with high-energy, blunt trauma with or without associated fracture | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
[[File:CT of Morel-Lavallee lesion.jpg|thumb| Morel-Lavallee lesion is a closed traumatic soft-tissue degloving injury, caused by separation of the hypodermis from the underlying fascia. It most frequently occurs in the peritrochanteric region along the proximal lateral thigh, such as in this CT scan.]] | |||
*Evaluate for tenderness, fluctuance | *Evaluate for tenderness, fluctuance | ||
*Labs | *Labs | ||
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==See Also== | ==See Also== | ||
==External Links== | ==External Links== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Trauma]] | |||
Latest revision as of 22:50, 5 August 2020
Background
- Posttraumatic, closed degloving injury[1]
- Results in subcutaneous fluid collection after abrupt separation of skin and subcutaneous tissues from underlying fascia[2]
- Disrupts capillaries and lymphatics resulting in leakage of lymph, blood, and necrotic fat
- Most commonly seen in proximal thigh or overlying hip
- Also reported in trunk, prepatellar region, lumbar region, or scapular regions
- If not diagnosed early, can become infected
Clinical Features
- Enlarging, painful area of swelling
- Soft tissue fluctuance
- Associated with high-energy, blunt trauma with or without associated fracture
Differential Diagnosis
- Hematoma
- Hemangioma/Vascular malformation
- Tumor
- Cyst
- Abscess
- Deep venous thrombosis
- Compartment syndrome
- Septic joint
- Necrotizing fasciitis
Extremity trauma
- Compartment syndrome
- Contusion
- Crush syndrome
- Degloving injury
- Fracture
- Laceration
- Myositis ossificans
- Open joint injury
- Peripheral nerve injury
- Rhabdomyolysis
- Tendon injury
- Vascular injury
Skin and Soft Tissue Infection
- Cellulitis
- Erysipelas
- Lymphangitis
- Folliculitis
- Hidradenitis suppurativa
- Skin abscess
- Necrotizing soft tissue infections
- Mycobacterium marinum
Look-A-Likes
- Sporotrichosis
- Osteomyelitis
- Deep venous thrombosis
- Pyomyositis
- Purple glove syndrome
- Tuberculosis (tuberculous inflammation of the skin)
Evaluation
- Evaluate for tenderness, fluctuance
- Labs
- CBC- can have significant bleeding into the lesion, watch Hb
- Imaging
- MRI is modality of choice for evaluation, but these lesions are also visible on CT
- Ultrasound can show a fluid collection, but can't be used to rule out
Management
- Will require surgical consultation and drainage
Disposition
- Admit
See Also
External Links
References
- ↑ Nair AV, Nazar P, Sekhar R, Ramachandran P, Moorthy S. Morel-Lavallée lesion: A closed degloving injury that requires real attention. The Indian Journal of Radiology & Imaging. 2014;24(3):288-290. doi:10.4103/0971-3026.137053.
- ↑ J Emerg Med. 2015 Jul;49(1):e1-4. doi: 10.1016/j.jemermed.2014.12.084. Epub 2015 Apr 2.