Chondral fracture

Case contributed by Tawfiq Abukeshek
Diagnosis almost certain

Presentation

History of trauma since 2 weeks followed by persistent left knee pain and swelling.

Patient Data

Age: 20 years
Gender: Male
mri

The anterior half of the lateral femoral condyle exhibits a full-thickness articular cartilage defect accompanied by subjacent bone marrow edema. Additionally, an intra-articular loose body is observed: a detached chondral fragment located in the anterior-medial aspect of the lateral tibiofemoral compartment.

A triangular band of grade 2c signal intensity is traversing the posterior horn of the medial meniscus not reaching the articular surface nor the meniscocapsular junction.

Moderate knee joint effusion is present.

Annotated image

Detached chondral fragment, seen as an intra-articular loose body with full-thickness articular cartilage defect at the donor site.

Case Discussion

Imaging findings reveal a traumatic chondral fracture on the lateral femoral condyle, accompanied by a detached chondral fragment observed as an intra-articular loose body. Donor site bone marrow edema and joint effusion are also noted.

Chondral fractures are fractures that involve cartilage only unlike osteochondral fractures where the articular cartilage, as well as the subchondral bone plate, are involved.

Chondral fractures typically occur in combination with ligamentous injuries in young adults but can be seen in isolation in adolescents.

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