de Wilde Robin, Hautekiet Arne, Geers Sybille, Vanden Bossche Luc, de Muynck Martine
Physical and Rehabilitation Medicine, Ghent University Hospital.
Physical and Rehabilitation Medicine, Maria Middelares General Hospital, Ghent, Belgium.
J Rehabil Med Clin Commun. 2022 Sep 22;5:2237. doi: 10.2340/jrmcc.v5.2237. eCollection 2022.
Morel-Lavallée lesion is a well-known entity after a high-energy, shearing trauma. Another form of lesion in the subcutaneous tissue is fat necrosis, presenting as a palpable mass. The most common presentation of fat necrosis is oil cysts, which occur mainly in the breast. However, in the lower extremities fat necrosis appears as nodular cystic fat necrosis. We report here a case of a patient with multiple injuries after a low-velocity trauma, who developed fat necrosis.
Six months after the traumatic event the patient reported multiple subcutaneous lumps on the right knee. On ultrasonography, the probable diagnosis of post-traumatic fat necrosis with consequent development of nodular cystic fat necrosis was seen. The diagnosis was confirmed based on magnetic resonance imaging (MRI).
Fat necrosis should be included in the differential diagnosis in cases of tissue injuries after a trauma. Fat necrosis can present months or years after the initial injury. It is a benign entity and is the result of an organized haemorrhage, swelling and oedema that progresses with fibrosis. There is no absolute need for surgical treatment.
莫雷尔-拉瓦利埃损伤是高能剪切伤后一种广为人知的病症。皮下组织损伤的另一种形式是脂肪坏死,表现为可触及的肿块。脂肪坏死最常见的表现是油囊肿,主要发生在乳房。然而,在下肢,脂肪坏死表现为结节性囊性脂肪坏死。我们在此报告一例低速创伤后多处受伤并发生脂肪坏死的患者。
创伤事件发生六个月后,患者报告右膝出现多个皮下肿块。超声检查显示可能诊断为创伤后脂肪坏死并继发结节性囊性脂肪坏死。基于磁共振成像(MRI)确诊。
脂肪坏死应纳入创伤后组织损伤病例的鉴别诊断。脂肪坏死可在初始损伤数月或数年后出现。它是一种良性病症,是有组织的出血、肿胀和水肿伴纤维化进展的结果。并非绝对需要手术治疗。