Clinics in diagnostic imaging (164)

Abstract

A 31-year-old male motorcyclist presented to the emergency department after hitting the side of a car. He had been travelling at approximately 50 km/h. The patient sustained blunt trauma to the left knee and bilateral upper limb abrasions. He was alert and conscious on his arrival at the emergency department.Physical examination of the left knee revealed superficial abrasions and swelling over the patella. Anterior and posterior drawer tests and stress testing of the left knee joint were negative.

Clinical presentation and management of pelvic Morel–Lavallee injury in obese patients

“…The shear injury also causes disruption of capillaries, leading to effusion containing hemolymph and necrotic fat; this hemolymphatic collection ends up with formation of fibrous pseudocapsules which prevents fluid reabsorption and increases susceptibility toward infectious complications. [ 6 12 18 ]…”

“…Moreover, these lesions are usually present with underlying bone fractures, but might occur in isolation, and are mostly unilateral in nature. [ 12 ] MLLs are not necessarily associated with pelvic fractures, as it may also be associated with acetabular fractures or may occur with blunt trauma in the absence of bone fracture. [ 18 ]…”

“…MLL is a closed internal degloving injury resulted from a trauma of the proximal femur and pelvis as well as lumbar region, where the subcutaneous tissue is torn away from the underlying fascia, creating a cavity filled with hematoma and lymph. [ 12 ] “The size of these lesions is variable, ranging from small thin slivers of fluid to thickly encapsulated lesions many centimeters in diameter.”[ 13 ] The diagnosis is based on the clinical findings and reviews of initial imaging often on serial observations during the hospital course and follows up; few cases demanded a radiological confirmation. All charts and radiological studies were carefully reviewed to pick up the cases of MLL and document their incidence, delayed diagnosis, management strategies, responses, and clinical outcome.…”