Patient fell, now with knee pain…

April 9, 2013

Knee XR, Orthopedics, Trauma, XR

Knee dislocation

This patient has a knee dislocation with an avulsion fragment seen in the joint space.  The tibia/fibula are both rotated facing medial with the patella displaced to the medial side as well.  Lateral projections were unable to be obtained due to the patient being very uncomfortable however clinically the tibia seemed to be posterior to the distal femur. 

Knee post-reduction 2Knee post-reduction 1

MRI later showed complete tears of the anterior and posterior cruciate ligaments as well as the medial collateral and fibular collateral ligaments.  It also showed the tibial plateu fracture and a compression fracture of the distal femur.

What other imaging would you recommend for this patient in the emergent setting?

Author:  Russell Jones, MD

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EMREMS: Radiology in Emergency Medicine

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2 Comments on “Patient fell, now with knee pain…”

  1. docskalski Says:

    I would recommend CT in the emergent setting, which would have likely resolved the lateral plateau fx, and the tibial spine avulsions at the ACL/PCL inserions would be better evaluated … MRI would obviously be needed in the long rung to accurately evaluate the supporting soft tissue structures.


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