Lipohaemathrosis of the knee

Case contributed by Dr Radha Raghavan

Presentation

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

Patient Data

Age: 28
Gender: Male
CT

Joint effusion consisting of three layers was noted.

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 lipohaemarthrosis 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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Case information

rID: 18578
Case created: 13th Jul 2012
Last edited: 19th Nov 2015
Inclusion in quiz mode: Included

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