Morel-Lavallée lesion with ACL sprain - knee

Case contributed by Sunil Kalmath
Diagnosis almost certain

Presentation

Fell from motorbike 2 weeks ago. A late presentation to the hospital with a painful right knee.

Patient Data

Age: 40 years
Gender: Male

Right knee

mri

Partial tear of ACL.

Grade II strain injury of the lateral collateral ligament.

Grade I strain medial patellar retinaculum.

Medial meniscal tear with grade I changes.

Swollen and increased PD intensity of the articular surface of the patella in keeping with chondromalacia patella - Grade II.

Bony contusions in the lateral femoral condyle.

Morel-Lavallée lesion involving the anteromedial aspect of lower thigh - Mellado-Bencardino type I.

Varicosities of the great saphenous vein.

Case Discussion

This is a commonly seen soft tissue injury seen in motorcyclists involved in a road traffic accident when the limb makes contact with a stationary surface such as the road but the momentum of the body drags the underlying osseous framework forward resulting in shearing of the tissue. This dead space is then filled by hemorrhagic fluid which then undergoes aging or reorganization as seen in this case to a seroma.

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