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Lipohemarthrosis of knee

Case contributed by Radha Raghavan
Diagnosis certain

Presentation

Accident involving a two wheeler which he was pillion riding. Joint swelling.

Patient Data

Age: 30 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

ct

Joint effusion consisting of three layers.

Case Discussion

Lipohemarthrosis is defined as collection of fat and fluid (blood) within the joint usually following trauma.

It is seen in 40% of all intra-articular fractures of the knee. Most intraarticular fractures of the tibial plateau are known to present with lipohemarthrosis knee.

Conventional x-ray may not depict this condition. CT scan is diagnostic as it shows the characteristic three layers:

  • fat which being lightest settles to the top
  • the middle layer consists of serous joint effusion
  • the inferior layer being the cellular components of blood

In conclusion lipohemarthrosis is highly suggestive of intra-articular fracture. Accurate diagnosis is essential as it will decide whether surgical or conservative treatment is to be adopted.

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