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Confusion Over a Contusion

A 20-year-old female presents to the Emergency Department for progressively worsening right thigh pain after a motor vehicle collision two weeks ago in which she was an unrestrained front passenger. Examination of the right lower extremity demonstrates a fluctuant collection that is tender to palpation along the lateral and posterior thigh. There is no erythema or warmth, the compartments are soft, and neurovascular examination is normal. Plain films of the femur and knee show no acute fracture or dislocation.


Confusion Over a Contusion

Authors: Steven Morrin, MD and Nick Copeli, MD
Peer-reviewer: Victor Huang, MD, CAQ-SM
Editor: Victor Huang, MD, CAQ-SM, Alex Tomesch, MD, CAQ-SM

A 20-year-old female presents to the Emergency Department for progressively worsening right thigh pain after a motor vehicle collision two weeks ago in which she was an unrestrained front passenger. Examination of the right lower extremity demonstrates a fluctuant collection that is tender to palpation along the lateral and posterior thigh. There is no erythema or warmth, the compartments are soft, and neurovascular examination is normal. Plain films of the femur and knee show no acute fracture or dislocation.

Image 1. Image Prompt. CT Lower Extremity with IV Contrast. Authors’ own images. 



 

References

[1] Singh R, Rymer B, Youssef B, Lim J. The Morel-Lavallée lesion and its management: A review of the literature. J Orthop. 2018;15(4):917-921. Published 2018 Aug 28. doi:10.1016/j.jor.2018.08.032

[2] Jalota L, Ukaigwe A, Jain S. Diagnosis and Management of Closed Internal Degloving Injuries: The Morel-Lavallée Lesion. J Emerg Med. 2015;49(1):e1-e4. doi:10.1016/j.jemermed.2014.12.084

[3] Shen C, Peng JP, Chen XD. Efficacy of treatment in peri-pelvic Morel-Lavallee lesion: a systematic review of the literature. Arch Orthop Trauma Surg. 2013;133(5):635-640. doi:10.1007/s00402-013-1703-z

[4] Tejwani SG, Cohen SB, Bradley JP. Management of Morel-Lavallee lesion of the knee: twenty-seven cases in the national football league. Am J Sports Med. 2007;35(7):1162-1167. doi:10.1177/0363546507299448

[5] Amaravathi U, Singh S, Reddy AA, Mohammed M A, Ayyan SM. The Morel-Lavallée lesionLavalleeLavelle. J Emerg Med. 2023;64(1):67-69. doi:10.1016/j.jemermed.2022.10.012

[6] Scolaro JA, Chao T, Zamorano DP. The Morel-Lavallée Lesion: Diagnosis and Management. J Am Acad Orthop Surg. 2016;24(10):667-672. doi:10.5435/JAAOS-D-15-00181

[7]Mellado JM, Bencardino JT. Morel-Lavallée lesion: review with emphasis on MR imaging. Magn Reson Imaging Clin N Am. 2005;13(4):775-782. doi:10.1016/j.mric.2005.08.006

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