Which radiologic signs suggest an underlying tibial plateau fractures?

Updated: Jul 05, 2018
  • Author: Srinivasa Vidyadhara, MBBS, DNB, MS(Orth), DNB(Orth), FNB(SpineSurg), MNAMS; Chief Editor: Thomas M DeBerardino, MD  more...
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Answer

The following subtle radiologic signs may indicate the presence of an underlying plateau fracture:

  • Lipohemarthrosis - The presence of a fat/fluid level in the suprapatellar recess on the horizontal-beam lateral projection of the knee indicates that a fracture has occurred and has allowed fatty marrow to enter the joint
  • Increased trabecular density beneath the lateral plateau on an AP film - The medial tibial condyle normally has greater trabecular density because it bears more body weight
  • Nonalignment of the femoral condyles and tibia on the AP view

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