Morel-Lavellée lesions: MRI characteristics in the pediatric patient

Rapp, Jordan B.; Barrera, Christian A.; Ho-Fung, Víctor

doi:10.1007/s00247-018-4328-0

Cited by 2 publications

(4 citation statements)

References 17 publications

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“…Lesions are usually ovoid shape and may contain septa, internal blood products and thick capsule. The presence of the internal fat droplet in the collection is an important criteria for the diagnosis of the Morel-Lavallée and it is required for differential diagnosis from other posttraumatic pathologies such as hematoma and prepatellar bursitis (7,8).…”

Section: Discussionmentioning

confidence: 99%

“…The continued growth of the lesion may result in denervation by causing fat and/or skin necrosis as a result of the mass effect (6,9). It is critical to better understand the imaging findings of these traumatic degloving injuries because approximately half (44%) of MLL are misdiagnosed during the initial examination (7).…”

Section: Discussionmentioning

confidence: 99%

“…The majority of patients receive conservative management but older age (>11 years old), the presence of the hemorrhagic content and thick capsule in the collection are MRI findings that can guide the clinician in determining the need for percutaneous drainage. MLL can be misdiagnosed by clinicians-radiologists since they are not very common in the pediatric age group, so Morel-Lavallée should definitely be considered in the differential diagnosis, especially in the presence of a subcutaneous collection in the anterior knee (7,8).…”

Section: Discussionmentioning

confidence: 99%

“…This cycle is thought to be responsible for the lesions' continuous growth and development. Because MLS lesions are rare and their diagnosis may be delayed due to trauma history, approximately half of the patients' diagnoses are missed (6,7).…”

Section: Introductionmentioning

confidence: 99%

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MR imaging characteristics of Morel-Lavallee lesions in pediatric patients

Kazci

Şenbil

Şahap

et al. 2022

Journal of Health Sciences and Medicine

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Aim: Morel-Lavallée syndrome (MLS) is a serious posttraumatic soft tissue injury in which the subcutaneous tissues are separated from the underlying fascia by glove-finger (closed type) peeling and replaced by a cavity filled with hematoma and fat. It is most commonly seen in the trochanter major, but it can also be found in the flank, hip, and lumbodorsal regions. The goal of this study is to define the typical findings of MLS in order to avoid misdiagnosis and delay in patient treatment. Material and Method: This retrospective study was approved by the Institutional Review Board. Informed consent was waived due to the retrospective nature of the study. Between 2015 and 2021, MR images and clinical follow-ups of 22 pediatric patients with clinical and radiological Morel-Lavallée lesions (MLL) were reviewed retrospectively. All patients were evaluated using 1.5T or 3T power MR devices (Siemens Healthineers, Erlangen, Germany). Results: Of 22 patients diagnosed with MLS, 77% (n=17) were male and 23% (n=5) were female. Patients ranged in age from 7 to 18 years, with a mean of 13.2 years (+/-2,3). The locations of MLL were knee (77%, n=17, 15 patients had anterior knee and 2 patients had posterior knee involvement), hip (14%, n=3) and thigh (9%, n=2) in order of frequency. These lesions all had a similar ovoid shape. The majority of patients (18/22) received solely conservative management but three patients underwent percutaneous drainage. Conclusion: In our study, the importance of differential diagnosis of MLL from traumatic collections and the importance of MRI findings in diagnosis and treatment were discussed. Accurate diagnosis and treatment of MLL are critical, as the lesion's size may increase as a result of delayed treatment, causing skin necrosis and denervation due to the mass effect.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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MR imaging characteristics of Morel-Lavallee lesions in pediatric patients

Kazci

Şenbil

Şahap

et al. 2022

Journal of Health Sciences and Medicine

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Delayed Onset of Pediatric Morel-Lavallée Lesion: A Case Report

Remien¹,

Khemka²,

Person³

et al. 2023

JOCR

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Introduction: A Morel-Lavallée lesion (MLL) is a closed degloving injury secondary to shearing forces. MLL is a rare, easily overlooked diagnosis, especially in those without recent trauma or fracture. Patients will present with ecchymosis, edema, fluctuance, and skin hypermobility or tightness. We present a case of pediatric MLL that was initially challenging to diagnose as the inciting trauma was 2 months before her diagnosis. Case Report: A 14-year-old girl presented with 5 days of left leg bruising, swelling, and pain. Two months prior, she collided with another softball player’s cleat and developed a hairline fracture. Magnetic resonance imaging of the left lower extremity (LLE) showed a closed, soft-tissue degloving injury, and she was diagnosed with a MLL. Throughout her admission, she had improvement in her bruising but continued to have pain with ambulation that was somewhat alleviated with the use of a compression stocking. Pediatric Orthopedic Surgery and Interventional Radiology were consulted, and a conservative approach was recommended with 3 months of LLE compression. Conclusion: MLL typically occurs in patients in their 30–40 s and rarely occurs in children. Identifying MLL in children is essential as children are more susceptible to shock and multi-organ damage from blunt trauma than adults. They are also more vulnerable to fractures and deep organ injuries. In the setting of MLL, children can quickly develop hypovolemic shock due to lower blood volumes and necrosis secondary to mass effect in the dead space. MLL should be included on the differential for children with trauma or a history of a shearing injury. Keywords: Pediatrics, orthopedics, bruising, trauma.

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Morel-Lavellée lesions: MRI characteristics in the pediatric patient

Cited by 2 publications

References 17 publications

MR imaging characteristics of Morel-Lavallee lesions in pediatric patients

MR imaging characteristics of Morel-Lavallee lesions in pediatric patients

Delayed Onset of Pediatric Morel-Lavallée Lesion: A Case Report

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