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never visited LATERAL PLATEAU FRACTURE AND FIBULAR HEAD FRACTURE
Contributed by: Fritsch & Thompson, Radiologist, Diagnostic Radiology of Houston, Texas, USA.
Patient: 42 year old male
History:

Rule out fracture/internal derangement.

This case has no images yet.
Findings:

MRI:
MRI examination of the right knee reveals the following:

Osseous elements: There is a nondisplaced lateral tibial plateau incomplete fracture clearly seen on coronal images 7, 8 and 9 and sagittal images 16, 17, 18 and 19. The fracture line does extend to the posterolateral corner of the knee. Additionally, there is a nondisplaced stellate complex fracture of the fibular head and neck clearly seen on sagittal images 20 and 21 and coronal images 5 and 6. Associated edema secondary to this acute fracture is visualized throughout the lateral aspect of the tibia, fibular head and proximal fibula. Additionally, there is a smaller fracture line in the lateral aspect of the lateral femoral condyle clearly seen on coronal image 7 with associated edema in the lateral femoral condyle.


Medial compartment: There are no meniscal tears. The MCL is intact. Articular cartilage is well maintained.


Cruciate ligaments: ACL and PCL are intact.


Lateral compartment: Other than the prominent fractures noted above, there are no definitive meniscal tears identified. There are mild mucoid degenerative changes in the intrasubstance of the meniscus. The LCL, popliteal tendon and ITB do not show any tears.


Patellofemoral compartment: There is adequate alignment of the knee. A mild effusion is present. There are no osteochondral lesions and the patellar tendon is unremarkable.

XRAY:

X-ray examination reveals a nondisplaced lateral plateau fracture with a curvilinear sclerotic compressive fracture deformity in the lateral tibial plateau clearly seen on the AP and lateral views. Nondisplaced fracture of the proximal fibula is also seen best on the oblique and lateral views disrupting the posteromedial margin of the fibular head and neck. Alignment of the knee remains adequate. There is intra-articular soft tissue swelling identified. No abnormal masses or calcifications revealed.

Diagnosis:

MRI CONCLUSIONS:

1. NONDISPLACED LATERAL PLATEAU FRACTURE EXTENDING TO THE POSTEROLATERAL CORNER OF THE KNEE.

2. COMPLEX STELLATE NONDISPLACED FRACTURE OF THE FIBULAR HEAD AND NECK.

3. OCCULT FRACTURE OF THE LATERAL ASPECT OF THE FEMORAL CONDYLE.

4. NO MENISCAL TEARS OR LIGAMENT TEARS IDENTIFIED.

5. MILD EFFUSION OF THE KNEE.

XRAY CONCLUSIONS:

1. INCOMPLETE COMPRESSIVE NONDISPLACED LATERAL PLATEAU FRACTURE.

2. FIBULAR HEAD AND NECK NONDISPLACED FRACTURE.

3. INTRA-ARTICULAR SOFT TISSUE SWELLING.

References:

REFERRING PHYSICIAN: JACK BARNETT, DC

Comments:
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Additional Details:

Case Number: 17717156Last Updated: 07-23-2008
Anatomy: Skeletal System   Pathology: Trauma
Modality: Conventional Radiograph, MRAccess Level: Readable by all users

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