Radiologycal assessment of irreducible posterolateral knee subluxation after dislocation due to interposition of the vastus medialis

while skiing. Pain and total impotence resulting from trauma required the patient to be transferred to our hospilal for the management of a suspected posttraumatic dislocation of the right knee.

The clinical examination was immedialery performed in Ihe emergency room by an orthopaedic surgeon. Then (bepatient sequentially underwent anteroposterior and lateral conventional radiographs, computed tomography angiography of the lower limbs, and MR1 of ihe right knee. The patient wax finally treated by open surgery for reduction and stabilisation Result

On arrival, the patient presented considerable swelling of the right knee with medial cutaneous incarceration known as a 'simple sign. The mobility was limited wilh knee flexion at SO" and impossibility of flexion/extension movements. There was no detectable neurovascular disorder.

Peripheral pulses, skin colour, and local lemperarure were symmetric in both legs. Sensibility was normal and motor Fig. below oil old mate Sis peeled of posrtja unlade airdudbtr knee hib luxation after dii local »m Preoperative photografi and ilustrated the caracteristic simple sign' function seemed to be limited only by flexion and pain, without a suspected neurological deficit.

Anteroposterior and lateral conventional radiographs showed a discrete avulsion of the lateral femoral condyle, suggesting a ligamentous tear of the lateral collateral ligament, an enlargement of the medial femorodbial space, an

important effusion, and a medial soft tissue attraction.

Computed tomography angiography wilh contrast injeelion in the arterial phase excluded arterial injury associated with ihe dislocation. Finally, magnetic resonance imaging proved vastus medialis partial incarceration within the intercondylar notch, associated with medial patelo femorotibial trapping of the medial patellofemoral ligament, capsule, and subcutaneous tissue. Associated ligamentous tears included complete rupture of ihe anterior and posterior cruciate ligaments as well as internal and external collateral ligaments.

Less than 24 h after the patiens arrival, all of Ihe imaging described above was performed and ihe patient underwent surgical reduction by parapatellar medial arthrotomy. At the same lime, stabilisation of the knee was provided by reinsertion of the medial palellolemoral ligament, posterior oblique ligament, and medial collateral ligament Cruciate ligament surgery was not undertaken for this patient The patient evolved favourably and was discharged from (he orthopaedic unit 15 days after surgery. Consultation centrals with oral interview and clinical examination at 6 weeks, 3 months, and o" months confirmed this favourable evolution in terms of healing, pain, joint stability, and passive and active range of motion. The patient resumed his normal professional and extra-professional activities less than I year after the accident.

Discussion

Knee dislocation is defined as a complete loss offemorotibial congruence and subluxation as a disruption, with parts of the articular surfaces remaining in contact. The classifications are based on the tibial displacement or on the pattern of ligament injury. The tibial displacement may be anterior (40 %), posterior (33 %), lateral (18 %), medial (4 %\ or rotatory (5 %) Later, Schenck et al. proposed a more biomechanical classification, using the pattern of ligament

injury, and this classification has finally been modified by Wascher et al. lo include associated lesions as vascular, neurological, or osseous. This modified Schenck classification is the most commonly used in clinical practice.

Posttraumatic knee dislocations are rare and generally reduced spontaneously or by a closed method Most of the rime, their irreducibility is associated wilh interposition of soft tissue structures such as the medial meniscus, capsule, retinaculum, and vastus medialis in poslerolaleial dislocations.

image

Radiologynet Tags:

Artikel Terkait

Radiologycal assessment of irreducible posterolateral knee subluxation after dislocation due to interposition of the vastus medialis
4/ 5
Oleh

Berlangganan

Suka dengan artikel di atas? Silakan berlangganan gratis via email

This below all content of radiology information

Neuroradiology Musculoskeletal radiology MRI Musculoskeletal MRI Abnormal Mri Brain X-RAY differential diagnosis Head Neck Anatomy mnemonic CT Teleradiology Radiology News chest Radiology musculoskeletal salary pediatrics ultrasound ultrasound images job Brain tumour abdomen interventional radiology CT Abdomen with contrast DAMS Imaging Apk Android radiology ramblings residency c nature pediatric radiology random ramblings xray C T Radiology Top basics body imaging guide procedure web 2.0 Chest X Ray Interpretation Teleradiology Providers head and neck radiology video Fun b cancer chest radiology salary 1 CXR GenitoUrinary ORTHOPEDICS Sonographic Measurements Stroke Ultrasound Hepatitis dams md/ms coaching mammography radiology business tuberculosis BRAIN Clinicoradiological series FETUS GI radiology Gastrointestinal x ray Radiology 4 Radiology Conferences Radiology Images Telemedicine UPPER LIMPS Ultrasound in Emergencies dynamic MRI lifestyle radiology links renal case spine 3 tesla MRI Dams clinicoradiological series Entrepreneur Gastrointestinal Tract Images Literature Liver abscess ultrasound MD/MS coaching Radiology 40 Radiology Imaging Radiology Journal Radiology PDF Radiology mcqs Ultrasound Technique blog bone tumour cardiac CT career cerebral venous thrombosis chest xray d fracture gadolinium gastrointestinal genitourinary radiology hepatobiliary imaging lipoma medical blogs mri lower abdomen pelvis psychiatry radiation concern social networking technology training urogenital imaging weblog 3D CT Arachnoid cyst CT Cardiac Chest X Ray Diploma Guid Equipment Cost FDA Fibrous dysplasia Interventional Ultrasound Guiding Biopsi MDCT MR Pancreas MRI Vertebrae MRI Vertebrae lumbal MRI contrast MRS RTA Radiology Teaching resource TB Hip TECHNIQUE Tech Thorax X Ray Upper Ext aiims ankle sprain bowel cancer brain abscess case study computers and radiology contrast ependymoma epidermoid facebook guest post internet journal of radiology iphone kienbock disease liver liver segments ct locum tenens mri abdomen multislice CT pericallosal lipoma plain film teaching files private practice radiology humour shoulder arthrogram shoulder dislocation small bowel social media trigeminal neuralgia tuberous sclerosis venous x ray Vertebrae 3d printing 7 tesla MRI ACL reconstruction ACL tear ACLS AIIMS nov 2008 ALPSA lesion ANGIOGRAPHY ATFL B12 deficiency BLS BOLD Breast imaging Breast imaging Mammography CHF CT Paranasal CT Scanner Price CT angiography CT coronary angiography CT technology CV junction CXR teaching files Carcinoid Contrast Agent Creutzfeldt-Jakob Disease Dams MD/ms Dams grand rounds Diffusion weighted imaging Dysmenorrhea E E World Award 2011 EYE Embolization Imaging Entrepreneurship FMG India FMGE FNH Focal liver lesions ultrasound Focal nodular hyperplasia GBM GI Gall bladder Glioblastoma multiforme Glomus jugulare HEAD HEART HRCT HSG Head injury ICA dissection IRIA 2011 IUGR IVC filter Iliotibial Band Friction Syndrome Job Info Kidney Cancer LV thrombus Leptomeningeal cyst MAMOGRAPHY MCI Screening MD MPPG MR mammography MR urography MRA MRCP MRI Cervical MRI update MRI/PET MRV Mesenteric ischemia Middle East respiratory syndrome coronavirus (MERS-CoV) Motor neuron disease NECK Normal Liver US Oncology trial PDF Radiology PM and R Physician PNS Partial anomalous pulmonary venous drainage Persistent trigeminal artery Pg entrance Physiatrist Physiatry Physician Assistant Plastic Surgery Price MRI Machines 2017 Pulmonology Pulvinar sign Radiology Price List Radiology Today Radiology Updates Radiology grandrounds Radiology images of GI Tract Renal Ultrasound Retinal Surgery Rheumatology Ryles tube SKULL Seizure Sellar Masses Sleep Medicine Sports Medicine Subdural hematoma Surgery TBM TRIANGULAR FIBROCARTILAGE COMPLEX Trauma Surgery URI Ultrasound HIV Umbilical vein Update Article Upper Extremity X Ray Urology Usmle VHL Vascular Surgery Veteran Affairs X Ray Head about accessory bone acute cerebillitis acute pancreatitis aiims may 2011 aipg ankle ankle fracture apple articular cartilage aspergilloma atherosclerosis avulsion injury awards bankart lesion basilar artery thrombosis bilateral phaeochromocytoma biopsy bipolar bohler's angle bone tumours brachial plexus brain tb brainstem stroke branchial cyst breast cancer screening buford complex business today calcaneal fracture calcium scoring canned reports carcinoma esophagus carcinoma stomach cardiac ct/pet cardiac pacemaker cardiogen 82 cardiothoracic imaging catrotid artery dissection cavernoma cervical lymphnode levels chest radiographic score chest radiographs choledocolithiasis classification cloud computing cochlear implant colloid cyst communication in radiology compare case concha bullosa congenital brain anomalies congenital heart disease coronary CT coronary artery disease corpus callosum agenesis craniopharyngioma cryptococcal meningitis ct abdomen and pelvis cystic renal disease dams usmle dams visual treat deep brain stimulator dengue dengue hemorrhagic fever developmental dysplasia devices diagnostic imaging dialysis diffusion MR imaging diffusion tensor imaging diffusion tractography digital radiography distal facial neuroma dsa duplication gall bladder echinococcus echocardiography ectopic kidney elearning elevated diaphragm epilepsy esop facial neuroma fibular osteosarcoma functional mri gastrointenstinal tuberculosis germinoma gifts glioma google google plus gun shot injury haemangioblastoma health 2.0 healthcare consultancy hemangiblastoma hemophilia hippocampus hirayama disease hydatid cyst hypercoagulable hypoxic ischemic encephalopathy indian conferences inferior rectus anomaly infrared interior tomography interstitial lung disease intramedullary metastates intramedullary tuberculomas ipad ipad 2 jacoud's arthropathy kernohan's notch knee kohler's disease krukenberg tumour laceration leber's optic atrophy liver transplant lung contusion lymphatics macros marchifava bingami disease mastoiditis maxillary sinus mucocele medial malleolus ossicle medial tibial stress syndrome medical writting medicare medicolegal aspects of teleradiology migraine mortality motor area mri knee mri lumbal msk penang course mucinous cystadenoma multicentric Glioblastoma multiforme mycotic pseudoaneurysm of superficial temporal artery nephrogenic systemic fibrosis nephrology neurosurgery meets nonradiologist oesophagus olecranon spur online medical games open access opercular syndrome opinion orbit os odontoideum os radiale externum osirix osteochondritis osteochondroma osteoid osteoma outsourcing radiology ovarian tumour parameniscal cyst paranasal sinuses parotid vascular mass patellar sleeve avulsion fracture patent ductus arteriosus patent foramen ovale patient information pelvic MRI pericardial fat phaeochromocytoma pharmaceutical writting pineal tumour placenta accreta placenta increta placental insufficiency pneumococcal pneumonia polycystic kidney disease portal Hypertension posterior circulation stroke power point presentation primary complex protected health information pseudobulbar palsy pseudomyxoma peritonei publications pulmonary edema pulmonary embolism pulmonary tuberculosis rabbit ear sign rad radiographic deterioration pattern radiography radiolo radiologist blogs radiology city radiology debate radiology images of spleen radiology intervensional radiology learning radiology search engine radiology spotter radiology spotters radiolopolis raditudes rathke cleft cyst renal imaging renal sinus tumour right sided aortic arch robot round cell tumour sacral agenesis scaphoid fracture schatzki ring scientific content screening search engine secondaries secondary ossification centres silicosis social radiology soft tissue chondroma solitary pulmonary nodule spectroscopy spinal arachnoid cyst spinal cord tumours spinal osteochondroma spine tumour spinoglenoid cyst sternal tuberculosis stress fracture sacrum stroke mri sub-acute combined degeneration subclavian pseudoaneurysm subependymal giant cell astrocytoma sumer sethi swyer-james syndrome syringomyelia tb teaching video teleradiolo teleradiology business models teleradproviders teleultrasound temporal bone fracture tendoachilles testicular tumour tethered cord. MRI tibial stress fracture total knee arthroplasty total shoulder replacment trachea. tracheal diverticulum tracheal stenosis tracheomalacia traumatic lung cyst triceps tear triquetral fracture tubercular abscess tuberculoma tuberculosis elbow ultrasound image of The segments of the liver umblical artery doppler uroradiology vascular malformation vasovist venous angioma ventriculitis video ct scan video mri viral encephalitis vitamin deficiency