A 17-year-old female presented to the gynaecology OPD with complains of primary amenorrhea, short stature and absence of secondary sexual characters. Her height was 135cm and weight of 30 kg with normal intelligence. She was born of consanguineous marriage and had normal milestones. Her siblings were normal and did not have similar complaints.On examination, her vitals were PR -66/min, BP -110/68 mm Hg; CVS, RS, CNS examination showed no significant findings. On local examination, there was no pubic hair, no axillary hair and no breast bud development. On examination of external genitalia labia majora and minora were developed but clitoris was underdeveloped. On laboratory investigations, blood routine, renal function test and thyroid function test were normal. FSH was elevated but LH was in normal range.She was referred to radiology department for Ultrasonography of abdomen which revealed horse shoe kidney with absence of uterus and ovaries. MRI abdomen and pelvis confirmed the absence of uterus and ovaries [Table /Fig-1a,b] along with the presence of horse shoe kidney [Table/ Fig-2a-c]. MRI brain was screened for any pituitary pathology in view of amenorrhea, but turned out to be normal [Table /Fig-3a,b]. With the suspicion of Turner's syndrome, karyotyping was performed which supports the diagnosis by the absence of one X chromosome (45 XO) [Table /Fig-4].Hence a diagnosis of Turner's syndrome with mullerian agenesis was made. A skeletal survey was performed as a workup for Turner's syndrome which showed positive metacarpal sign-shortening of 4 th metacarpal [Table/ Fig-5]. A 2D echo was performed to look for bicuspid aortic valve and was negative. Screening of chest for coarctation of aorta was taken which showed normal aortic knuckle and no inferior rib notching-ruling out any abnormality.Patient was counseled and was put on Estrogen therapy for the development of secondary sexual characters. DISCUSSIONDuring the first 6 weeks of development the male and female fetus is indistinguishable which demonstrates both mesonephric and para mesonephric duct. The presence of Y chromosome is associated with production of mullerian inhibiting factor [1].

A 52-year-old female presented to the radiology department with swelling over the posterolateral aspect of upper portion of left foreram and arm region with nagging pain over the swelling. She gave history of injury one week prior to her current visit. Swelling appeared about two days after the injury and was gradually increasing over time. Clinical examination revealed a fluctuant, tender and boggy swelling over the posterolateral aspect of upper part of forearm and distal arm. Laboratory evaluation showed elevated leucocyte count and ESR. Plain radiograph revealed well defined soft tissue swelling on the posterolateral aspect of upper part of forearm and lateral aspect of arm [Table/ Fig-1,2]. Ultrasonography was done which revealed a hypoechoic collection with floating internal echoes in the posterolateral aspect of arm between the subcutaneous plane and deep fascia. Few fat lobules were also noted within the collection 4]. Similar anechoic collection noted in proximal aspect of left lateral forearm between the subcutaneous plane and deep fascia b]. On MRI, the collection at lateral aspect of arm was hyperintense on T2WI/STIR and hypointense on T1WI in the nondependent region with hyperintensity on T1 and T2 in dependent region with demonstration of fluid levels [Table/ Fig-5a,b]. The lesion in the arm measured 5.6 cm (Anteroposterior) x 2.7 cm (Transverse) x 3.2 cm (Craniocaudal). Few fat lobules were noted within this collection [Table/ Fig-6a,b]. A well defined cystic collection was noted over the posterolateral aspect of foreram which is hyperintense on T2WI/STIR and hypointense on T1WI [Table/ Fig-7,8]. The lesion in forearm measured 9 cm (craniocaudal) x 1.2 cm (transverse) x 0.6 cm (anteroposterior). Both the collections were located deep to the subcutaneous plane, superficial to the muscular compartment. The lesions were hypointense on T1WI and were hyperintense in T2WI and STIR [Table/ Fig-8]. Visualized muscles and rest of the soft tissue were normal. Left elbow joint was normal. Based on the history, clinical features and MRI characteristics the diagnosis of Morel-Lavallee lesion was made. Differential diagnosis include haemangioma, fat necrosis and subcutaneous haematoma. Since the lesion was unencapsulated, percutaneous decompression and evacuation of the collection was performed. There was complete resolution of the swelling clinically. Follow up showed complete resolution of collection but images are not available. AbSTRACTMorel-Lavallee lesions are closed degloving soft tissue injuries which occur because of trauma and in which the skin and subcutaneous tissue are separated from superficial fascia. This shear trauma results in creation of a potential space filled with serosanguinous fluid, blood and necrotic fat. We discuss a case of 52-year-old female with history of trauma one week back, who presented with a boggy swelling over the postero-lateral aspect of proximal forearm and distal arm. Local examination showed fluctuating fluid collection. MRI showed variable intensity fluid collection ...