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Atraumatic hemarthrosis caused by a large mediopatellar plica
Z Yamamoto1, A Fujita, G Minami
1Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan. ort072@poh.osaka-med.ac.jp
Summary
A rare case of atraumatic knee hemarthrosis caused by a hypertrophic mediopatellar plica is presented. Surgical excision of the plica and associated tissue resolved the patient's symptoms, highlighting an unusual cause of knee bleeding.
Area of Science:
- Orthopedics
- Sports Medicine
- Knee Surgery
Background:
- Hemarthrosis of the knee is typically traumatic, but atraumatic causes exist.
- Synovial plica syndrome can cause knee pain, but hemarthrosis is an exceptionally rare manifestation.
- This case explores an unusual etiology of atraumatic hemarthrosis in a young male patient.
Observation:
- A 21-year-old male presented with recurrent atraumatic right knee swelling and pain, particularly during flexion.
- Initial arthrocentesis revealed bloody synovial fluid; MRI showed a hypertrophic mediopatellar plica and infrapatellar fat pad changes.
- Arthroscopy confirmed a voluminous mediopatellar plica entrapped between the patella and medial femoral condyle, causing bleeding.
Findings:
- The bleeding originated from the interface between the mediopatellar plica and the infrapatellar fat pad (tongue).
- Histological examination of the excised tissue revealed bleeding and nonspecific synovitis.
- Surgical excision of the mediopatellar plica and tongue successfully treated the hemarthrosis.
Implications:
- This case underscores the importance of considering synovial plica as a rare cause of atraumatic knee hemarthrosis.
- Prompt diagnosis and surgical intervention can lead to excellent outcomes for this condition.
- Further research may elucidate the specific mechanisms leading to plica-induced hemarthrosis.