Assessment #1 case-set #4 case #9 vanderbilt

Large joint effusion, likely hemoarthroses in setting of trauma. No lips-hemarthrosis. No definite fracture, although one could be occult, consider CT or MRI in osteopenic elderly patient. Severe degenerative changes, predominantly medial compartment.

The patella is slightly more lateral than normal thus suspicious for a patellofemoral dislocation. Additionally there is a joint effusion and soft tissue swelling anterior to the patella.
Tricompartmental osteoarthritis of the left knee. Quadriceps tendon enthesophyte.
No acute fracture.

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There is tibiofemoral malalignment with narrowing of the medial compartment. There is also a knee joint effusion. No visible acute fracture. Evidence of arthritic changes with osteophyte formation and sclerosis of the medial femoral and tibial condyles.

No radiographic evidence of acute fracture.
Large lipohemarthrosis concerning for occult fracture. Recommend CT.

patellar ligament disruption

Ostepenia.

Layering joint effusion consistent with lipohemarthrosis.

Severe medial compartment osteoarthritis with marginal osteophytosis.

prepatella soft tissue edema.

No occult fx, lipohemarthrosis

no visible fracture, however, there is small to moderate lipohemoarthrosis, suggestive of occult fracture. consider CT for further evaluation. joints normally aligned. moderate to severe tricompartmental osteoarthritic changes

FINDINGS:

No acute fracture identified. The medial compartment is narrowed. There is a large lipohemarthrosis. Degenerative changes at the knee. Patellar enthesophyte.

IMPRESSION:

Large lipohemarthrosis without an acute fracture visualized radiographically. This raises concern for an occult injury. Recommend MRI for further evaluation.

Joint effusion, soft tissue swelling,

Large lipohemarthrosis. While no distinct fracture line is identified on this study, the presence of a lipohemarthrosis indicates that there is a radiooccult fracture. Recommend CT for further evaluation.
Severe degenerative changes of the medial compartment. Mild degenerative changes of the lateral and patellofemoral compartments.

Lipohemarthrosis without definite fx line suggesting occult fx. Possible lat tibial plataeu nondisplaced fx. suggest further eval with CT. Osteoarthritis. Patellar enthesophyte.

1. No acute fracture or traumatic malignment. However, lipohemarthrosis is present and is frequently associated with ligamentous injury. Consider MRI for further evaluation.
2. Tricompartmental osteoarthritis, which is moderate to severe in the medial and patellofemoral compartments and mild within the lateral compartment.
3. Anterior superior patellar enthesopathy.

Severe degen changes of the medial compartment.
Soft tissue swelling inferior to the patella.
Lipohemarthrosis.
Patellar enthesopathy.

Lipohemarthrosis without definite fracture. Findings raise concern for occult fracture.

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soft tissue thickening over the patella. Left knee hemoarthrosis. Cortical irregularity of the superior aspect of the patella. Recommend MRI for further evaluation of the left knee.

Acute fracture of the proximal patella. Lipohemarthrosis. Prepatellar edema.

patella fracture

Acute medial femoral condyle fracture with large lipohemarthosis. Tricompartmental degenerative changes, severe in the medial compartment and moderate in the lateral and patellofemoral.
Patellar enthesopathy.

Acute fracture of the medial tibial plateau.

acute medial femoral condyle fx with lipohemathrosis and soft tissue swelling

Acute comminuted fracture of the patella without significant displacement or malalignment.

Large lipohemarthrosis with marked prepatellar and Kager’s fat pad soft tissue edema and swelling.

Osteopenia.

Mild patellar enthesophytes along the superior pole.

Moderate medial compartment and mild patellofemoral and lateral compartmental degenerative changes.

Fracture
Effusion

Lateral condylar impaction fracture (femoral notch sign). This finding can be associated with ACL tear. Consider further evaluation with MRI.

Prepatellar soft tissue swelling. Vascular calcifications. Soft tissue reticulation and edema of the thigh and leg.

Moderate lipohemarthrosis.

Tricompartmental degenerative changes, severe of the medial and mild of the lateral and patellofemoral compartments.

Cortical irregularity of the medial tibial condyle may represent and acute nondisplaced extraarticular fracture. Lipohemarthrosis present. Soft tissue swelling. Tricompartmental degenerative changes. Patellar enthesopathy.

Acute lateral tibial plateau fracture with minimal depression measuring xx. Large lipohemarthrosis.

Moderate tricompartmental degenerative changes.

Moderate lipohemarthrosis. Depression of the lateral tibial plateau concerning for impaction fracture. Question superiormedial patellar fracture with fragment minimally displaced seen on PA view. Rec CT for further evaluation.
Moderate tricompartmental degen.

Large lipohemarthrosis, maybe lateral tin plateau fx. Tricompartmental degen, soft tissue swelling ant to patella

Large lipohemarthrosis without definitive fracture. Query lucency through the tibial spine concerning for acute fracture. Cortical irregularity about the lateral aspect of the medial femoral condyle is favored to be artifactual in nature but may represent acute fracture. Recommend CT knee to further evaluate.

Moderate lipohemarthrosis. No definite fx but highly suggestive of fx. Consider CT for further evaluation.

large lipohemearthrosis which indicates acute fracture. No acute fracture is definitively identified. Possibly the supueromedial patella or the tibial plateau.
Consider CT for further evaluation.

Lateral tibial plateau impaction fracture with lipohemarthrosis.

Knee joint liphemarthrosis.

Probable lateral tibial plateau fracture, with slight superior displacement of a fracture fragment.

Severe tricompartmental degenerative changes.

Acute depressed fracture of the lateral tibial plateau.
Lipohemarthrosis.
Moderate medial compartment and patellofemoral compartment degen.
Patellar enthesopathy.

cortical irregularities along the lateral tibial plateau with associated lipohemarthrosis, concerning for acute lateral tibial plateau fracture, which could be further evaluated with MRI.

extensive tricompartmental degenerative changes

osteopenia

Acute fracture of the lateral tibial metaphysis with large lipohemarthrosis,. Possible additional lateral femoral condylar fracture, recommend CT for further evaluation.
Patellar enthesopathy. Severe degenerative changes of the medial compartment. Moderate degenerative changes of the lateral and patellofemoral compartment.

tibial fracture with lipohemarthrosis. recommend CT.

Moderate to large lipohemarthrosis suggesting acute intra-articular fracture. However, no acute fracture line is identified. Mild irregularity and lucency at the tibial spines may represent an avulsion fracture or overlapping structures. CT could further evaluate. Moderate tricompartmental degenerative changes. Patellar enthesopathy.

lipohemarthrosis
query lateral condyle fx, ct can eval
mod degen-med comp, patell.fem.

acute medial tibia plat fracture with mild impaction.

large lipohemarthosis and extensive soft tissue swelling

mri or ct could further eval for femoral condylar fractures

ostepenia

osteophyte/degen vs fragmentation along medial aspect of tibial platesu. Large lipheme concerning for underlying fracture. CT could further eval.

lateral tibial platueal

Tibial plateau fracture with lipohemarthrosis

Lateral tibial plateau fracture with mild inferior displacement and large lipohemarthrosis.

lat tib plat fx

Lipohemarthrosis without obvious displaced fracture. Given lipohemarthrosis, there is likely a tibial plateau fracture (possibly wedge fractures of the lateral and medial tibial plateaus). Recommend CT for further evaluation.

Acute minimally displaced fracture of the lateral tibial plateau. Moderate volume lipohemarthrosis. Moderate tricompartmental degenerative changes.

Lipohemarthrosis which raises concern for occult fracture. Consider CT or MRI for further evaluation.
Query minimally depressed lateral tibial plateau fracture.
Moderate tricompartmental degenerative changes.

Acute fracutre of the medial tibial plateau (reverse segond) with lipohemarthrosis. No malalignment.

Fracture in lateral tibia.

tibial plateau fx, lipohemarthrosis

Acute lateral tibial plateau fracture with large lipohemarthrosis. Question lateral patellar dislocation.

Acute mildly comminuted depressed lateral tibial plateau fracture. Recommend CT to further assess for radiographically occult fractures.

Moderate lipohemarthrosis

bad degen.

Lateral tibia plateau fracture with minimal depression of the lateral tibial plateau fracture fragment.

tibial plateau fracture w lipohemarthrosis

Medial joint space narrowing, liphemarthrosis from patellar fx

Large lipohemarthrosis with subtle depressed fracture of lateral tibial plateau. Could be further evaluated with MRI.

Impacted medial tibial plataeu fracture. Lipohemarthrosis. Degen

Occult fracture, likely tibial plateau. Lipohemarthrosis. Medial joint space narrowing with degenerative changes.

Tibial plateau fracture with superior displacement of the patella and lipohemarthrosis