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Sharma et al. Morel-Lavalle lesion

A A B

Flow
movements
B

C

Figure 1: Photograph of the right leg with focal swelling. (A) fronto-
lateral position of the thigh shows swelling on upper lateral part with No flow
slight discoloration (white solid arrow); (B) magnified view of the same
swelling shows normal overlying skin surface (hollow white arrow)
A B
Figure 3: Ultrasound images showing the movement of the fluid.
(A) few uniform soft echoes within the fluid (white arrow) because
of haemolymph; (B) flow moments in the fluid because of different
density of blood and lymph; (C) no color flow seen in and around
the cycstic fluid in color flow imaging
was done with the high frequency linear probe for
this swelling and showed predominantly anechoic
collection seen under the skin soft tissue extending up
to deep fascia without traversing it. A few echogenic
foci were present within and at the periphery of the
collection [Figure 2].
C D
The movement of the fluid was seen while scanning
after changing the position of the affected limb. There
was no vascularity seen within the collection or from
the edges of the swelling [Figure 3].

She underwent magnetic resonance imaging (MRI)
and revealed the fluid collection underneath the skin
but not extending into the deep fascia. The collection
was hypointense on T1W and hyperintense on T2W
sequences. T1W with fat suppression sequences
showed suppression of the fatty lobules seen from the
margins and inside the collection [Figure 4].
Figure 2: Greyscale images of the swelling with high frequency
linear probe. (A) anechoic fluid in encapsulated space (white star)
with echogenic fat lobule hanging against the margin (white arrow); There was evidence of “fluid-fluid” levels seen within
(B) another similar image with fat lobule on the anterior aspect the swelling [Figure 5].
(upward arrow); (C) anechoic pure fluid in the space (white star); (D)
two echogenic fat lobules (white arrows) hanging in the fluid
The patient was treated initially managed conservatively
Plain X-ray of the right thigh and upper hip did not with no relief, and subsequently underwent surgical
show any bony injury. Ultrasound (US) examination drainage with an uneventful recovery. The patient will

336 Plastic and Aesthetic Research ¦ Volume 3 ¦ October 25, 2016