Dislocated proximal tibiofibular joint

Case contributed by Dr Craig Hacking

Presentation

Twisted knee in sport

Patient Data

Age: 20
Gender: Female

The fibular head is laterally dislocated relative to the proximal tibiofibular joint. No fracture, joint effusion or lipohaemarthrosis. Normal patellofemoral alignment.

No fracture identified. The proximal tibiofibular joint is subluxed anterolaterally. Patella alta and thickening of the proximal patellar tendon with mild cortical irregularity along the inferior margin of the patella. This may represent jumpers knee. Previous Osgood Schlater's disease also evident.

The proximal fibular remains subluxed. There is injury to the anterior bundles of the conjoined tendon. The popliteal muscle is swollen and of high signal however the popliteus tendon is intact. Appearances are in keeping with a strain.

There is fluid overlying the iliac tibial band, which is intact. Appearances indicate a superficial anterolateral joint capsule injury.

There is evidence of a patellar tendon avulsion injury with irregular inferior patellar cortex, mild marrow oedema and a indistinct proximal small tendon. This is of indeterminate chronicity. Ossified body within the distal popliteal tendon suggestive of previous injury.

No patellar osteochondral defect identified. There is a small joint effusion.

The anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament and lateral collateral ligaments are intact. Both medial and lateral menisci are intact. There is no marrow oedema in the distal femur or proximal tibia.

Conclusion

  1. Superficial anterolateral joint capsule injury and popliteus muscle strain.
  2. Focal patellar tendon avulsion injury of indeterminate chronicity.

Case Discussion

Dislocated proximal tibiofibular joint are almost always associated with posterolateral corner ligamentous injuries

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Case information

rID: 39346
Case created: 1st Sep 2015
Last edited: 28th Sep 2016
Inclusion in quiz mode: Included

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