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Case Reports
. 2022 Sep 22:5:2237.
doi: 10.2340/jrmcc.v5.2237. eCollection 2022.

ULTRASONOGRAPHIC PRESENTATION OF NODULAR CYSTIC FAT NECROSIS AFTER A LOW-VELOCITY TRAUMA: A CASE REPORT

Robin de Wilde  1   2 , Arne Hautekiet  2 , Sybille Geers  1 , Luc Vanden Bossche  1 , Martine de Muynck  1
Affiliations
Case Reports

ULTRASONOGRAPHIC PRESENTATION OF NODULAR CYSTIC FAT NECROSIS AFTER A LOW-VELOCITY TRAUMA: A CASE REPORT

Robin de Wilde et al. J Rehabil Med Clin Commun. .

Abstract

Objective: Morel-Lavallée lesion is a well-known entity after a high-energy, shearing trauma. Another form of lesion in the subcutaneous tissue is fat necrosis, presenting as a palpable mass. The most common presentation of fat necrosis is oil cysts, which occur mainly in the breast. However, in the lower extremities fat necrosis appears as nodular cystic fat necrosis. We report here a case of a patient with multiple injuries after a low-velocity trauma, who developed fat necrosis.

Results: Six months after the traumatic event the patient reported multiple subcutaneous lumps on the right knee. On ultrasonography, the probable diagnosis of post-traumatic fat necrosis with consequent development of nodular cystic fat necrosis was seen. The diagnosis was confirmed based on magnetic resonance imaging (MRI).

Discussion: Fat necrosis should be included in the differential diagnosis in cases of tissue injuries after a trauma. Fat necrosis can present months or years after the initial injury. It is a benign entity and is the result of an organized haemorrhage, swelling and oedema that progresses with fibrosis. There is no absolute need for surgical treatment.

Keywords: fat necrosis; rehabilitation; trauma; ultrasonography.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Ultrasonography images of the medial right knee (14MHz transducer). The sonographic characteristics of these findings are well-defined oval structures with an anechogenic appearance and capsule (arrows). There was no angiogenesis present or oedema around the structures. Some through transmission is present on the left-hand image.
Fig. 2
Fig. 2
Magnetic resonance imaging T2 TSE fat suppression transverse sequence of the right knee with nodular cystic fat necrosis (arrows).
See this image and copyright information in PMC

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