These Patients Knee’d Your Help
Knee pain, fracture, and dislocation are common consequences of car accidents and falls, but differentiating between x-rays can be an obstacle of its own. Four patients, four diagnoses—can you identify the problem represented in each radiograph?
Match the primary diagnosis to the photo by letter
a. Medially dislocated distal femur
b. Nondisplaced proximal fibula fracture
c. Lateral dislocation of the patella
d. Comminuted and depressed fracture of the lateral tibial plateau
For answers, see next issue; for discussion, go to https://www.mdedge.com/clinicianreviews/picture
1. A 23-year-old man is brought in after being hit by a car. There is a moderate amount of soft tissue swelling around the knee, with limited flexion and extension due to pain. He can wiggle his toes, and there appears to be no neurovascular compromise.
Diagnosis: The image shows a comminuted and depressed fracture of the lateral tibial plateau. It is depressed approximately 6 to 7 mm. The patient was admitted, and orthopedic consultation was obtained. The patient subsequently underwent an open reduction and internal fixation of the fracture.
For more information, see “Clipped by an Oncoming Car.” Clinician Reviews. 2014;24(6):23,36.
