Knee lipohemarthrosis due to tibial plateau fracture

Case contributed by Dr Andrew Dixon


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

Patient Data

Age: 40
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.   

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Case information

rID: 36602
Published: 1st May 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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