E2006. Taking the Gloves Off: Demystifying Degloving Morel-Lavallee Type Lesions
  1. Erica Lanser; University of Cincinnati
  2. Micheal Johnson; University of Cincinnati
  3. Eric England; University of Cincinnati
  4. Artemis Petrides; University of Cincinnati
French surgeon Maurice Morel-Lavallee first described a post-traumatic superficial fluid collection that occurred after a fall from a train in 1863, which was later understood to be caused by a closed degloving injury. Over time, the eponymous lesion was described specifically as occurring over the greater trochanter of the femur. Today, we understand the mechanism of degloving injuries resulting from direct or tangential shearing forces, which causes separation of the skin and subcutaneous tissues from the underlying fascia without an open defect. While commonly seen at the greater trochanter as Morel-Lavallee initially described, radiologists today encounter closed degloving injuries in many other anatomic locations often over bony protuberances. Acutely, this space fills with blood and lymph which, over time, develops into a chronic inflammatory process. As the blood products resorb there is continued serosanguinous accumulation and formation of a fibrous capsule. This encapsulation prevents reabsorption while allowing continued fluid accumulation. Prompt recognition of degloving-type injuries by radiologists is essential to ensure early treatment and prevent long-term morbidity. The purpose of this presentation is to review the pathophysiology of the classic Morel-Lavallee lesion, as well as atypical presentations of the classic Morel-Lavallee lesion. Additionally, we present a multimodality review of degloving injuries encountered in less common anatomical locations.

Educational Goals / Teaching Points
We review the underlying pathophysiology and development of closed degloving injuries including the classic Morel-Lavallee injury. Using a multimodality approach, we discuss closed degloving Morel-Lavallee type injuries encountered in less common anatomical locations, as well as unusual presentations of typical Morel-Lavallee lesions. Finally, we discuss early treatment options to prevent long-term morbidity.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We present a multimodality review of classic Morel-Lavallee lesions including MRI, CT and US. This includes a review of Morel-Lavallee type injuries in less common anatomical locations and with less common presentations including radiographic and sonographic findings with MRI correlation.

Maurice Morel-Lavallee first described the now eponymous lesion overlying the greater trochanter in 1863. However, today with a better understanding of the mechanism of injury and the pathophysiology of closed degloving-type injuries, we know that radiologists will encounter these types of lesions in many different anatomical locations. Prompt recognition of these lesions by radiologists is vital to guiding early intervention and prevention of long-term morbidity.