IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Knee lipohemarthrosis due to tibial plateau fracture

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Unable to walk following fall and twisting injury. ? knee fracture.

Patient Data

Age: 40 years
Gender: Male

On the lateral horizontal beam image a fat-fluid level is seen within the supra-patella joint recess consistent with a lipohemarthrosis. This indicates that there must be an intra-articular fracture despite the fact that no fracture can be confidently identified on either the lateral or the AP image. 

CT confirms the presence of a lipohemarthrosis and demonstrates a fracture of the anterior weight-bearing surface of the lateral tibial plateau which is depressed by around 2mm.   

Lipohemarthrosis of the knee. 

Case Discussion

An excellent example of how detecting a lipohemarthrosis on a horizontal beam lateral knee radiograph can alert the reader to the presence of a radiographically occult intra-articular fracture. In this case a significant fracture of the lateral tibial plateau is revealed upon CT evaluation.   

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.