Pneumolipohaemarthrosis

Case contributed by Dr Henry Knipe

Presentation

Motor vehicle collision. Right femoral fractures in external traction with absent peripheral pulses ?vascular injury.

Patient Data

Age: 30 years
Gender: Male
CT

Open comminuted fracture through the right distal femoral metadiaphysis extending to the patellofemoral joint. Vertically orientated patellar fracture. Posterior lateral tibial plateau fracture involving the posterior aspect of the intercondylar area, likely representing a PCL avulsion fracture.

Pneumolipohaemarthrosis. Right thigh and upper calf are swollen.

No gross arterial injury identified with small calibre but patent vessels and three-vessel run-off to the level of the ankle. Right common femoral, profunda femoris and popliteal arteries are of irregular calibre throughout, without intimal flap, most likely reflecting vasospasm.

CT

Zoomed CT images demonstrated presence of blood, fat and gas making a pneumolipohaemarthrosis. 

Case Discussion

Lipohaemarthrosis in the knee is indicative of an intra-articular injury with addition of intra-articular gas making a pneumolipohaemarthrosis, which indicates the fracture is open (compound). 

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Case information

rID: 49367
Case created: 21st Nov 2016
Last edited: 23rd Nov 2016
Inclusion in quiz mode: Excluded

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