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[Occult bone trauma detected by magnetic resonance imaging]
1Radiodiagnostické oddĕlení Nemocnice Na Homolce, Praha.
Acta Chirurgiae Orthopaedicae Et Traumatologiae Cechoslovaca
|February 1, 2003
Summary
Magnetic resonance imaging (MRI) effectively diagnosed an occult tibial plateau fracture in a young woman with knee pain. This advanced imaging revealed a subtle fracture missed by conventional X-rays, highlighting MRI
Area of Science:
- Orthopedics
- Radiology
- Sports Medicine
Background:
- Sport-related knee injuries often present with pain, swelling, and limited range of motion.
- Initial assessment may involve conventional radiography and joint aspiration.
- Hemarthrosis and lipohemarthrosis can indicate intra-articular pathology.
Observation:
- A 23-year-old female presented with acute left knee pain and swelling post-injury.
- Conventional radiographs were negative for fracture, but joint aspiration revealed hemarthrosis.
- Subsequent surgical examination noted persistent pain and swelling, with lipohemarthrosis confirmed.
Findings:
- Magnetic resonance imaging (MRI) identified a subchondral fracture of the posterior medial tibial condyle.
- The fracture was associated with increased intra-articular hemorrhagic fluid.
- Menisci and ligamentous structures were intact on MRI.
- Follow-up MRI showed fracture healing with residual bone marrow edema.
Implications:
- MRI is crucial for diagnosing occult bone fractures, especially when conventional radiographs are inconclusive.
- Early and accurate diagnosis of tibial plateau fractures is essential for appropriate management.
- Non-invasive imaging like MRI improves diagnostic yield in complex knee injuries.