Diagnosis and Management of a Morel-Lavallée Lesion in a Collegiate Female Soccer Player: A Type 4 Rare Event Case Study

This case study investigates the occurrence of a Morel-Lavallée Lesion in a Collegiate Female Soccer Player. After the second game of a double header, the patient reported to the certified athletic trainer (ATC) that her knee was swollen and bruised. An initial evaluation was inconclusive with differential diagnoses of a meniscus injury, a bone bruise, or bursitis. The team orthopedic agreed with these differential diagnoses following his evaluation. Magnetic Resonance Imaging (MRI) results found a pocket of edema along the anterior medial aspect of the knee that was approximately 2.6 x 0.9 x 3.5 cm large. With a meniscus injury ruled out by the MRI, the new diagnosis was a hematoma. Initial treatment focused on reducing swelling with deep oscillation therapy and a compression sleeve. The athlete did not improve as expected from typical treatment methods. After re-evaluation 16 days post-injury, the patient was diagnosed with a Morel-Lavallee Lesion (MLL). Options for treatment were conservative treatment, aspirating the lesion of fluid, injecting the lesion with an antibiotic, or surgically removing the lesion. Conservative treatment was chosen as the best option because the athlete was out of season and the lesion was not severe. Morel-Lavallée Lesions are a closed traumatic degloving injury, uncommon in athletics, most often occurring in motor vehicle accidents. The reported cases of Morel-Lavallee Lesions in athletes typically occur from the knee hitting the playing surface with a shearing force which aligns with the mechanism in this case study. The authors of this case study recommend that the Morel-Lavallee Lesion be added to the pathologies taught in athletic training education programs. Increased education may lead to more efficient diagnosis and proper injury management. Additionally, diagnosis in the acute phase allows patients to receive treatment before developing infection or tissue necrosis.