Morel-Lavallée Lesion of the Knee: A Case Report

Öz

Morel-Lavallée lesions are closed soft tissue injuries caused by a shearing force that separates the skin and superficial fascia from the deep fascia, creating a potential space where hemolymphatic fluid accumulates. These lesions are often misdiagnosed due to their variable clinical presentation and heterogeneous morphology, which can lead to confusion with conditions such as hematoma, fat necrosis, and sarcoma. The typical localization of the lesion is the trochanteric region. This case report presents the clinical and radiological findings, along with the diagnosis and treatment process, of a 56-year-old female patient who developed a Morel-Lavallée lesion in the prepatellar region following a fall. In the first stage, no bone abnormality was seen in computed tomography (CT) imaging. Magnetic resonance imaging (MRI) and ultrasonography (USG) performed as a result of her ongoing complaints revealed a well-defined fluid accumulation in the prepatellar region, consistent with a Morel Lavallée lesion. Clinical examination and patient history are essential for diagnosis. However, MRI and USG play an important role in confirming the diagnosis and monitoring the course of the disease. A classification has been proposed for Morel-Lavallée lesions, which are divided into six subtypes based on MRI features. USG is particularly practical and useful modality both for initial diagnosis and follow-up evaluation. Some lesions may resolve spontaneously. If not recognized and treated appropriately, they may become chronic or complicated, requiring more invasive interventions. Recognizing the lesion’s characteristics and implementing a personalized treatment strategy are essential for achieving optimal patient outcomes.

Anahtar Kelimeler

• Morel-Lavallée lesion
• knee
• degloving injury
• ultrasound

Dizde Morel-Lavallée Lezyonu: Olgu Sunumu

Öz

Morel-Lavallée lezyonları, deri ve yüzeysel fasya ile derin fasyayı ayıran ve hemolenfatik sıvının biriktiği potansiyel bir boşluk yaratan bir kesme kuvvetinin neden olduğu kapalı yumuşak doku yaralanmalarıdır. Bu lezyonlar, değişken klinik sunumları ve hematom, yağ nekrozu ve sarkom gibi durumlarla karıştırılmasına yol açabilen heterojen morfolojileri nedeniyle sıklıkla yanlış teşhis edilir. Lezyonun tipik lokalizasyonu trokanterik bölgedir. Bu olgu sunumunda ise, düşme sonrası prepatellar bölgede Morel-Lavallée lezyonu gelişen 56 yaşında bir kadın hastanın klinik ve radyolojik bulguları ile beraber tanı ve tedavi süreci sunulmaktadır. İlk aşamada, bilgisayarlı tomografi (BT) görüntülemesinde kemik anormalliği görülmemiştir. Devam eden şikayetleri sonucunda yapılan manyetik rezonans görüntüleme (MRG) ve ultrasonografi (USG), Morel Lavallée lezyonuyla uyumlu, prepatellar bölgede iyi tanımlanmış bir sıvı birikimi ortaya koymuştur. Tanı için klinik muayene ve hastanın öyküsü esastır. Ancak tanıyı doğrulamak ve hastalığın seyrini izlemek için MR ve USG önemli rol oynar. Morel Lavallée lezyonları için MRI özelliklerine dayanan altı alt tipe ayrıldığı bir sınıflandırma önerilmiştir. USG de hem ilk tanı aşamasında hem de takip değerlendirmesi için oldukça pratik ve kullanışlı bir yöntemdir. Bazı lezyonlar kendiliğinden çözülebilir. Uygun şekilde tanınmaz ve tedavi edilmezse kronikleşebilir veya komplike hale gelebilir ve daha invaziv müdahaleler gerektirebilir. Lezyonun özelliklerini tanımak ve kişiselleştirilmiş bir tedavi stratejisi uygulamak, optimum hasta sonuçlarına ulaşmak için esastır.

Anahtar Kelimeler

• Morel-Lavallée lezyonu
• diz
• soyulma yaralanması
• ultrason

Kaynakça

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