Radiology Teaching Files > Case 35092741

Contributed by: Sheldon Jensen, Resident, Brooke Army Medical Center, Texas, USA.
Patient: 30 year old male
History: 30 year old male: gets on top of his roof on New Years Eve to get a better view of the fireworks.  He fell off.

Fig. 1: Comminuted fracture of the right tibial plateau. Fracture of proximal fibula.

Fig. 2: Comminuted fracture of the tibial plateau with lipohemarthrosis. Fracture of proximal fibula.
Findings: Comminuted fracture of the tibial plateau.  Lateral view demonstrates lipohemarthrosis. 
Diagnosis: Comminuted tibial plateau fracture.
Discussion: Lipohemarthrosis is a fluid-fluid level caused by less-dense fat layering above more-dense blood products.  Post-traumatic lipohemarthrosis is caused by bleeding from laceration of synovial vessels or leakage from marrow cavity.  Lipohemarthrosis always signifies intra-articular fracture.  This is the only way marrow fat can enter joint.
References: StatDX,, Hemarthrosis and Lipohemarthrosis.  Accessed 07 January 2010.  Author:  James F. Griffith.  Last updated 21 October 2007.
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Additional Details:

Case Number: 35092741Last Updated: 01-07-2010
Anatomy: Skeletal System   Pathology: Trauma
Modality: Conventional RadiographAccess Level: Readable by all users
Keywords: tibial plateau fracture, lipohemarthrosis

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