Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

The Knee


Knee Checklists

1

Radiographic examination

  • AP

  • Obliques (internal and external)

  • Cross-table lateral

  • Sunrise view of patella

2

Hemarthrosis/lipohemarthrosis – distention of suprapatellar bursa

  • Important clue to

    • Underlying obscure fractures

    • Cruciate and collateral ligament and meniscal injuries

      • Most commonly ACL tear

3

Common sites of injury in adults

  • Patella

  • Tibial plateau

  • Distal femur

    • Metaphysis/intercondylar

  • Proximal fibula

    • Head

    • Neck

  • Flake/avulsions

    • Osteochondral fractures

      • Joint surface patella or femoral condyles

    • Tibial spine – avulsion ACL

    • Posterior tibial plateau – avulsion PCL

    • Segond fracture – lateral tibial plateau just distal to joint line

      • Sign of ACL tear

    • Reverse Segond fracture – medial tibial plateau just distal to joint line

      • Sign of PCL tear

    • Proximal tip head of fibula – arcuate sign

      • Sign of injury ligamentous and meniscal structures of the posterolateral corner

4

Common sites of injury in children and adolescents

  • Patella

  • Anterior tibial tubercle

  • Anterior tibial spine

  • Buckle fracture proximal anterior tibial metaphysis

  • Toddlers’ fracture tibial shaft

  • Distal femoral and proximal tibial epiphyseal injuries are rare.

5

Injuries likely to be missed

  • Subtle tibial plateau fractures

    • Often not seen on AP or lateral views

    • Need oblique views to identify fracture

  • Fine, linear intraarticular bone fragment indicating osteochondral fracture

  • Small avulsion fractures about tibial plateau

    • Segond fracture, etc. (See 3 Flake/avulsions)

You're Reading a Preview

Become a Clinical Tree membership for Full access and enjoy Unlimited articles

Become membership

If you are a member. Log in here

Related Posts