The Morel-Lavallée lesion: pathophysiology, clinical presentation, imaging features, and treatment options

Abstract

Morel-Lavallée lesions are posttraumatic hemolymphatic collections related to shearing injury and disruption of interfascial planes between subcutaneous soft tissue and muscle. We review the pathophysiology of Morel-Lavallée lesions, clinical presentation, and potential sites of involvement. Magnetic resonance imaging (MRI) is the modality of choice for characterization. We present the MRI classification and highlight the key imaging features that distinguish the different types, focusing on the three most common: seroma, subacute hematoma, and chronic organizing hematoma. Potential mimics of Morel-Lavallée lesions, such as soft tissue sarcoma and hemorrhagic prepatellar bursitis, are compared and contrasted. Treatment options and a management algorithm are also briefly discussed.

The importance of morel-lavallee lesion in medicolegal evaluation: a case report

“…The Morel-Lavallee Lesion (MLL) was first described by the French Doctor Maurice Morel-Lavallee in 1863 [1][2][3][4][5]. The blunt trauma or tangential force to the fascia results in tearing of the trans-aponeurotic vessels by the separation of the immobile fascia under the mobile subcutaneous tissue.…”

“…The blunt trauma or tangential force to the fascia results in tearing of the trans-aponeurotic vessels by the separation of the immobile fascia under the mobile subcutaneous tissue. Thus, a cavity comes into being due to the accumulation of hematomas and lymphocele, including necrotic and damaged skin tissues [1][2][3][4][5][6][7][8][9]. MLL is also referred to as "closed internal degloving injury", "Posttraumatic soft tissue cyst", "Morel-Lavallee extravasation or effusion" and "Chronic expanding hematoma".…”

“…MLL is also referred to as "closed internal degloving injury", "Posttraumatic soft tissue cyst", "Morel-Lavallee extravasation or effusion" and "Chronic expanding hematoma". MLL is often the result of traffic accidents, but it can also be seen in people who play sports with close contact, such as football or wrestling [1,2,3,7]. MLL diagnosis is often delayed because clinical findings are variable and subcutaneous tissue injury are masked by skin findings [4,7,8].…”

“…MLL diagnosis is often delayed because clinical findings are variable and subcutaneous tissue injury are masked by skin findings [4,7,8]. It can occur in hours or days or even months or even years after the trauma [1,2,3,6]. Clinical findings such as swelling, ecchymosis, tension, pain, hypoesthesia in the lesion area and skin deformity can be detected in these cases [2,4].…”

“…Diagnosis is based on USG, CT and MR imaging methods besides physical examination findings [2,3,6,7]. Treatment of acute or chronic lesions may vary [1][2][3][4]6,8,9]. In this case report, a 55-year-old female who was referred to our department by the court was evaluated.…”