title: Ankle Morel-Lavallée lesion in a recreational racquetball player.
abstract: Unilateral ankle swelling is a relatively common presenting complaint among athletes and non-athletes. Due to its broad differential diagnosis, a comprehensive evaluation beginning with history and physical examination are recommended. Imaging including plain radiography, ultrasound (US), and magnetic resonance imaging (MRI) are preferred modalities. Aspiration of a local fluctuating mass may help with the diagnosis and management of some of these conditions. Morel-Lavallée lesion (MLL) is a rare condition consisting of a closed degloving injury caused by forces of pressure and shear stress between the subcutaneous tissue and the superficial fascia or bone. Most commonly MLL is found over the greater trochanter and sacrum, but in rare cases can be found in other regions of the body. In most cases concurrent severe injury mechanisms like motor vehicle accidents are present. MLL due to sports injuries are rare. Depending on the stage and type of MLL, therapeutic strategies may vary from compression wraps and aspiration to surgical evacuation. We present a case of a 65-year-old gentleman with ankle MLL with no known history of a major trauma as a result of playing racquetball 6 weeks earlier. Physical examination revealed a transilluminating lesion in the lateral aspect of his left ankle which was successfully treated with one time aspiration of a serosanguinous fluid. We propose less aggressive methods for management of low-impact sports-related MLL.
authors.affiliation: Department of Family Medicine, University of Colorado School of Medicine, Denver, CO, USA - morteza.khodaee@ucdenver.edu.
authors.forename: Morteza
authors.initials: M
authors.lastname: Khodaee
authors.affiliation: Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Rajwinder S
authors.initials: RS
authors.lastname: Deu
mesh_terms: D000368:Aged; D016512:Ankle Injuries / Q000175:diagnosis* / Q000628:therapy; D000069836:Degloving Injuries / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010808:Physical Examination / Q000379:methods*; D015865:Racquet Sports / Q000293:injuries*; D011859:Radiography; D017695:Soft Tissue Injuries / Q000175:diagnosis*; D014172:Transillumination; D014463:Ultrasonography