WWWTP #18 Answer

September 11, 2014

WWWTP


This is a classic knee film in an elderly lady who fell.  What is the finding and diagnosis?

lipohemarthrosis-1 edits

Just anterior to the distal femur there is an example of lipohemarthrosis.  Note the horizontal line seen in the suprapatellar pouch (blue arrow).  This occurs when fat and blood have been released into the joint space and creates an interface (fats don’t mix with mostly water-based blood).  The fat has been released from an occult fracture, most commonly a tibial plateau or distal femur fracture.  If you can’t see the fracture it may be a good idea to obtain further imaging (CT or MRI) or refer the patient to an orthopedic surgeon.

Author:  Russell Jones, MD

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