Chondral fracture: knee
A 12 year old male presented with pain and swelling of the left knee after a sports injury
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There is a large chondral fracture involving the lateral trochlear facet with the avulsed cartilaginous fragment floating within a large suprapatellar joint effusion. Also seen is moderate to severe edema within the vastus lateralis and lateral head of the gastrocnemius muscles, compatible with a moderate to severe strain.
Chondral fractures occur when there is trauma to the joint surface without breaking the underlying bone. Injury is most common in weight bearing regions of articular cartilage. They most often occur in the medial femoral condyle of young adults following a direct blow to the knee or following a rotational injury. Clinically, chondral fracture mimics a torn meniscus, and may or may not be associated with meniscal tears. Chondral fractures may cause persistent pain, locking, buckling, swelling, or crepitus of the knee.