Morel-Lavallée lesion: Difference between revisions
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==Background== | ==Background== | ||
*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> | *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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==See Also== | ==See Also== | ||
==External Links== | ==External Links== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 16:56, 27 March 2018
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.