Identification and triage of a Morel-Lavallée lesion using point of care ultrasound

Abstract

Introduction A Morel-Lavallée lesion is a relatively rare, closed, degloving injury. Polytrauma and severe injuries through to seemingly innocuous trauma can distract the clinician from thorough assessment of the affected site. Missed or misdiagnosis of the closed lesion is reported from both a clinical and imaging perspective. Case report A 46-year-old male is discharged from accident and emergency with a shoulder injury following a cycling accident. Ten days post trauma, an advanced practice physiotherapist suspects a lateral thigh Morel-Lavallée lesion during a telephone assessment (Covid-19 restrictions). A face to face appointment with imaging the following day confirmed the suspicion. Discussion The aetiology, imaging and clinical management of a Morel-Lavallée lesion is discussed. The addition of diagnostic ultrasound skills to clinical assessment in this case report may have improved patient care and experience by offering a ‘one stop shop’ to care. Formal training in musculoskeletal ultrasound imaging is emphasised. Conclusion Thorough history taking, clinical reasoning and subsequent application of robust imaging led to the identification of a Morel-Lavellée lesion and, in this case, highlights the value of a point of care ultrasound model in a triage setting.