(Fig 5-E.13) Lipohemarthrosis and Intra-Articular Gas

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📌Lipohemarthrosis

 

✅Cause and Association 

• Lipohemarthrosis results from an intra-articular fracture with leakage of fat and blood from the bone marrow into the joint space. 
• It is most frequently observed in the knee and is associated with tibial plateau fracture. 

✅ Earliest Findings 

• The earliest findings of lipohemarthrosis include the presence of several fluid-fluid levels with entrapment of globules of fat. 
• The classic double fluid level can be expected several hours after injury. 

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📌Hemarthrosis

• Hemarthrosis most often occurs due to trauma but can also be seen with bleeding disorders and coagulopathy.

 

✅ Imaging Characteristics 

• Subacute blood products (e.g., methemoglobin) are intrinsically T1 hyperintense and often T2 hyperintense depending on the chronicity of the hemorrhage. 

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📌Intra-articular Gas

✅ Susceptibility Effects 

• Intra-articular gas can be identified by the susceptibility effects of air bubbles, which appear as focal rounded hypointense areas with adjacent thin hyperintense rims.

 

References

1. Semin Musculoskelet Radiol 2009;13:303–325.
2. Radiographics. 2023 May;43(5)
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#Radiology, #Lipohemarthrosis, #Hemarthrosis, #IntraArticularGas, #MRI, #Musculoskeletal, #KneeInjuries, #TibialPlateauFracture, #TraumaImaging,