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Figure 4: Longitudinal view of Morell Lavallee lesion
Figure 4: Longitudinal view of Morell Lavallee lesion

Morel-Lavallée lesion- Suresh Sudula, MSK Consultant Physiotherapist

This gentleman in his early 30's, had been referred with a nine week history of swelling over the lateral aspect of the left thigh.  He recalled being hit with a metal bar, and the swelling developing since. The patient reported the swelling had gone down  slightly but there was still a visible swelling present over the lateral aspect. He did not report any paraesthesia.

Demonstration of the location of Morel Lavallée lesion surface marking on the lateral thigh (not the patient)
Demonstration of the location of Morel Lavallée lesion, surface marking on the lateral thigh (not the patient)

On examination, there was a visible swelling over lateral aspect of the left thigh. There was no evidence of bruising. There was full range of movement of the knee and hip. There was no tenderness on palpation.

There is an anechoic, wide spread fluid collection that  measured about 10cm in length noted between subcutaneous fat and muscular fascia layer over the lateral aspect of the thigh. It is identified as fluid as it is compressible (Figure 2). Appearances are consistent with Morel-Lavallée lesion.

A Morel-Lavallée lesion is described in full with this free, full text article by Neal et al (2008). A further useful resource is here.

The patient went on to be managed with an ultrasound guided aspiration procedure, demonstrated in the video below.

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All feedback welcome at [email protected] More pathology demonstrated on ultrasound can be found in the video gallery and image gallery.

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