Organized prepatellar hematoma associated with severe varicose veins and revisiting prepatellar anatomy and hematomas

Background

While haemorrhagic bursitis and Morel Lavallee lesions occur in the prepatellar region, hematoma secondary to ruptured superficial vein, mimicking the above lesions, has not been reported. It is important to be aware of this entity as it would need further evaluation and surgical management.

Case report

We report a rare case of prepatellar hematoma of Right knee following a fall in a 72-year-old lady associated with severe varicose veins in both lower limbs, treated by evacuation and suction drain and followed by reinforcement sutures three days after the evacuation. There was no recurrence after the procedure. We discuss the MRI findings of our case, revisit the anatomy related to the prepatellar bursa, the differential diagnosis for a prepatellar hematoma, how to differentiate this lesion from others and their treatment options.

Conclusion

A detailed assessment of the patient is necessary to identify varicose veins in such cases which need surgical treatment to prevent recurrences or persistent ooze.