Long‐standing Morel‐Lavallée lesion in the proximal thigh: Ultrasound and MR findings with surgical and histopathological correlation

Puig, Josep; Peláez, Isabel María Gámez; Baños, J.L. Gutiérrez; Balliu, E.; Casas, M. Culiañez; Maroto, Albert; Pedraza, Salvador

doi:10.1111/j.1440-1673.2006.01640.x

Cited by 26 publications

(14 citation statements)

References 13 publications

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“…They appear as fluid collections, often with heterogeneous echogenicity. The echogenicity depends on the degradation stage of the blood products [19202122]; acute and subacute (<1 month) lesions will appear heterogeneous with irregular margins and lobular shape. The more acute the hematoma, the more hyperechoic the collection will appear.…”

Section: Discussionmentioning

confidence: 99%

Imaging Features of Morel-Lavallée Lesions

Coninck

Vanhoenacker²,

Verstraete

2017

Journal of the Belgian Society of Radiology

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Objectives:To review the imaging characteristics of Morel-Lavallée lesions with both ultrasound and magnetic resonance imaging (MRI).Materials and Methods:We retrospectively analyzed 31 patients (mean age = 46 years), diagnosed with a Morel-Lavallée lesion, on ultrasound (n = 15) or MRI (n = 16). On ultrasound the echogenicity, internal septations, hyperechoic fat globules, compressibility and Doppler signal were evaluated. On MRI, T1- and T2-signal intensity, capsule presence, internal septations, enhancement, mass-effect and fluid-fluid levels were assessed. The MR images were classified according to the classification of Mellado and Bencardino.Results:Most of the lesions were situated peritrochanteric, around the knee or the lower leg. The majority of the lesions had a heterogeneous hypoechoic appearance with septations and intralesional fat globules. On MRI, most of the collections were hypointense on T1-weighted images and hyperintense on T2-weighted images. Half of the collections were encapsulated, and most collections demonstrated septations. The collections were classified as seroma (n = 10), subacute hematoma (n = 2) and chronic organizing hematoma (n = 5).Conclusion:Ultrasound is the imaging method of choice to diagnose Morel-Lavallée lesions. MRI can be of use in selected cases (extension in different compartments, large collections, superinfection). Characteristic imaging features include a fusiform fluid collection between the subcutaneous fat and the underlying fascia with internal septations and fat globules. On MRI, six types of ML lesion can be differentiated, with the seroma, the subacute hematoma, and the chronic organizing hematoma being the most frequently observed lesions.

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Section: Discussionmentioning

confidence: 99%

Imaging Features of Morel-Lavallée Lesions

Coninck

Vanhoenacker²,

Verstraete

2017

Journal of the Belgian Society of Radiology

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“…There is an increased likelihood of underlying pelvic and acetabular fractures where these lesions are encountered [3, 4] and their presence is associated with increased surgical site infection rates [5, 6]. It is now accepted that these collections can be encountered at multiple locations in the body: head [7], abdominal wall [8, 9], pelvis [10], lumbosacral region [11, 12], gluteal [13, 14], thigh [15, 16], knee [7, 17], and calf [18]. …”

Section: Introductionmentioning

confidence: 99%

The Morel-Lavallée Lesion as a Rare Differential Diagnosis for Recalcitrant Bursitis of the Knee: Case Report and Literature Review

Vanhegan

Dala-Ali

Verhelst

et al. 2012

Case Reports in Orthopedics

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A 72 year-old-male was referred to our institution with recalcitrant prepatellar bursitis. The injury was sustained after striking his right knee against a post whilst horse riding 9 months ago. Previous treatments included repeated aspiration and excision of the bursa with elastic compression bandaging. A diagnosis of a Morel-Lavallée internal degloving injury was made, and the lesion was satisfactorily managed by an internal quilting procedure to eliminate the potential dead space. A review of the literature reveals 29 published reports of Morel-Lavallée lesions with sufficient information for inclusion. These came from 14 separate countries with a total of 204 lesions in 195 patients. The most common anatomical location was the greater trochanter/hip (36%), followed by the thigh (24%) and the pelvis (19%). Most were managed surgically with evacuation of the haematoma and necrotic tissue followed by debridement, which was often repeated (36%). Conservative treatment with percutaneous aspiration and compression bandaging was the next most common treatment (23%). The knee was the fourth most common region affected (16%), and only 3 other lesions in the literature have been managed with a quilting procedure.

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“…1 A traumatic insult results in the separation of subcutaneous tissue from the underlying fascia with accumulation of blood, lymph, fat, and debris in the potential space. [2][3][4] Morel-Lavallée lesions have a tendency to recur and can therefore become chronic sources of pain and infection.…”

mentioning

confidence: 99%

“…Several case reports and case series have characterized the appearance of Morel-Lavallée lesions by magnetic resonance imaging, showing variable signal characteristics depending on the age of the lesion. 3,[5][6][7] As the lesion ages, its signal follows that of a seroma: hypointense on T1weighted sequences and hyperintense on T2-weighted sequences. A hypointense capsule frequently surrounds the lesion in all sequences.…”

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confidence: 99%

Sonography of Morel-Lavallée Lesions

Neal

Jacobson

Brandon

et al. 2008

Journal of Ultrasound in Medicine

103

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All fluid collections (21/21) were located between the deep fat and fascia, with a shape that was fusiform in 12 (60%) of 20, flat in 5 (25%), and lobular in 3 (15%) (shape not determined in 1 case). Regarding echogenicity, 15 (71%) of the 21 collections were hypoechoic, and 6 (29%) were anechoic; 13 (62%) were heterogeneous, and 8 (38%) were homogeneous. The lobular fluid collections were all less than 2 weeks of age, and the flat fluid collections were all greater than 6 months of age. All homogeneous fluid collections were greater than 8 months of age. There was no relationship between the age of a fluid collection and its echogenicity. Conclusions. Morel-Lavallée lesions had a variable appearance, being more homogeneous and flat or fusiform in shape with a well-defined margin as the lesions aged. All Morel-Lavallée lesions were hypoechoic or anechoic, compressible, and located between the deep fat and overlying fascia.

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Long‐standing Morel‐Lavallée lesion in the proximal thigh: Ultrasound and MR findings with surgical and histopathological correlation

Cited by 26 publications

References 13 publications

Imaging Features of Morel-Lavallée Lesions

Imaging Features of Morel-Lavallée Lesions

The Morel-Lavallée Lesion as a Rare Differential Diagnosis for Recalcitrant Bursitis of the Knee: Case Report and Literature Review

Sonography of Morel-Lavallée Lesions

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