Morel-Lavallée Lesion - MSK Radiology
Imaging Findings:
• Large, smoothly marginated, well-circumscribed mass along the medial myofascial planes of the thigh within the subcutaneous tissues.
• Well defined acute angle at the margin of the lesion shear plane of the myofascial tissues.
• Low-intensity peripheral pseudocapsule surrounding the lesion.
• Nodules within the collection are of similar signal intensity to the subcutaneous fat (following fat-signal on all sequences.)
Case description:
• Closed degloving injury due to abrupt, posttraumatic separation of the skin and subcutaneous fat from the underlying fascia.
• Commonly in the peritrochanteric area.
• Appearance changes depending on chronicity but usually has components of fat nodules, blood products, and lymph:
- Acute/subacute: Irregular complex margins and internal heterogeneous signal.
- Chronic: Elongated and smooth margins with decreased heterogeneity.
• If a fibrous pseudocapsule is present; almost certain it will recur with conservative treatment alone. These usually require surgical debridement and resection.
Differential diagnosis:
• Abscess: Absence of symptoms of and/or clinical concern for infection. Also, no internal air density or avid rim enhancement.
• Neoplasm: Will have avid internal enhancement.
• Fat necrosis: Usually smaller and ill-defined with heterogeneous attenuation on CT.
Dr. Donald von Borstel @DrvonBorstel
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