Presentation
Two weeks prior to the presentation, degloving injury to the right leg anterior lateral side. Complaining of local pain, swelling, redness. No fever.
Patient Data
There is a subcutaneous collection in the right proximal-mid third leg. It is located on the anterolateral side. It abuts fascia. There are mobile, tiny internal echoes. There are a few avascular septa with fat lobules. There is a thin avascular capsule (< 2 mm) around most of the lesion. However, there is no capsule on the medial side of the lesion resulting in a few small (< 20 mm) unencapsulated collections. The approximate size of the lesion is 145 (craniocaudal) x 76 (transverse) x 19 mm (anteroposterior) and a volume of about 109 mL. The adjacent subcutaneous fat is echogenic. The underlying muscles reveal a normal echopattern.
Case Discussion
An adult male patient sustained blunt trauma to the leg resulting in local swelling, pain and skin changes. Ultrasound shows an encapsulating subcutaneous collection. As the ultrasound was done at two weeks post-trauma, there is incomplete capsule formation which is seen on the medial side of the collection. By end of the 3rd-4th week, there is likely to be a completely encapsulated collection which is actually a chronic hematoma.