Presentation
Right knee pain after football game: jumped and landed on to knee. On examination, pain over the medial side of his knee with pain when bearing weight. No significant past medical history.
Patient Data
Tibial plateau fracture with lipohemarthrosis.
In addition to the cortical irregularity in the medial tibial plateau (the fracture), there is a large joint effusion, best seen on the lateral view. The joint effusion contains a straight line, representing a fluid-fat level, with the lighter fat from the bone marrow ("lipo") floating above the heavier blood ("heme"). The straight line also reveals that the patient's leg is actually lying on a table and the film was rotated to present the knee in an upright position (the blood is layering dependently).
Case Discussion
Features are consistent with right tibial plateau fracture type IV (Schatzker classification) complicated with lipohemarthrosis.
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