Haematoma at the lateral hip

[Lena Truong]

Hello Stephen,

I was wondering if you could help me with this case. Patient fell whilst skating 8 days ago and there is a persistent huge bruise over the lateral hip aspect overlying the greater trochanter. Please find included the US findings for this patient. I was wondering how can you differentiate between a haematoma or a Morel Lavallee lesion?

Kind regards,
Lena

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[Stephen Bird]

Hi Lena,

What a classic case,

I don’t think you can tell the difference between an acute haematoma and a Morel Lavallee lesion at this stage.

They would look the same,

BUT,

With that history of acute shearing trauma and that location over the lateral hip it would be a classic Morel Lavallee lesion.

I would describe that as an acute haematoma, but given the history and location suggest that a Morel Lavallee lesion may persist.

The difference will be in the follow up,

If it is a simple haematoma it will resolve quickly,

If it is a Morel Lavallee lesion it will persist and be very recalcitrant.

Now if you ask my opinion as to the most likely outcome I would say with the location and history we will be seeing a Morel Lavallee lesion that will persist !

Time will tell.

My worksheet would describe it as an acute haematoma but given the classic location and history of shearing trauma a Morel Lavallee lesion needs to be a serious consideration.

Please let us know what transpires.

Happy scanning,

Steve

[Lena Truong]

Thank you Steve 🙂 Yes i’ll keep you updated if patient returns for follow-up

[Stephen Bird]

Thanks Lena,

Steve

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