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床旁超声诊断与治疗运动相关性莫雷尔-拉瓦利埃损伤:病例报告

Diagnosis and Treatment of a Sports-Related Morel Lavallée Lesion With Point-of-Care Ultrasound: A Case Study.

作者信息

Bronstein Ellis, Kounelis-Wuillaume Savannah, MaGill Colby, Leggit Jeffrey C

机构信息

School of Medicine, Uniformed Services University (USU), Bethesda, MD 20814, United States.

Department of Family Medicine, Uniformed Services University (USU), Bethesda, MD 20814, United States.

出版信息

Mil Med. 2025 Jul 23. doi: 10.1093/milmed/usaf378.

Abstract

Morel-Lavallée lesions (MLLs) are closed degloving injuries that result in inter-fascial hemolymphatic collections. These lesions develop as a result of shearing forces in the deep fascial planes and often arise in the context of significant high-velocity traumas. However, they are often underdiagnosed, especially in the case of atypical presentations such as sports or low-impact injuries. Here we present a case of MLL following a fall from a bike at low speed that resulted in a large area of soft-tissue ecchymosis and swelling that would not resolve following conservative treatment. Point-of-care ultrasound (POCUS) was used to diagnose and guide interventional treatment via ultrasound-guided drainage of the fluid collection. This case is informative as it serves as a reminder for providers to always consider MLL in the differential diagnosis of soft tissue injuries. It additionally demonstrates how POCUS can help identify and assist in management of MLLs in the primary care setting.

摘要

莫雷尔-拉瓦利埃损伤(MLLs)是一种闭合性脱套伤,可导致筋膜间血淋巴积聚。这些损伤是由深筋膜平面的剪切力引起的,通常发生在严重的高速创伤情况下。然而,它们常常被漏诊,尤其是在非典型表现的情况下,如运动损伤或低冲击力损伤。在此,我们报告一例低速骑自行车摔倒后发生莫雷尔-拉瓦利埃损伤的病例,该损伤导致大面积软组织瘀斑和肿胀,保守治疗后未消退。床旁超声(POCUS)用于诊断并通过超声引导下引流积液来指导介入治疗。该病例具有参考价值,因为它提醒医疗人员在软组织损伤的鉴别诊断中始终要考虑到莫雷尔-拉瓦利埃损伤。此外,它还展示了床旁超声在基层医疗环境中如何有助于识别和协助处理莫雷尔-拉瓦利埃损伤。

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