Musculoskeletal Imaging

Lipohaemarthrosis

the presence of fat droplets, blood and bone marrow spicules in the synovial fluid, usually indicative of an intra-articular fracture. Lipohaemarthrosis may also be seen in patients without fracture, however; in such cases the condition is presumably attributable to significant injury to cartilage or ligaments.

In cases of lipohaemarthrosis, radiographs obtained using horizontal beam technique may reveal a fat blood fluid level after a joint injury (Fig.1). The transaxial images provided by CT also demonstrate lipohaemarthrosis as a fat blood fluid level (Fig.2), but MR imaging is probably the most sensitive method in detecting this entity (Fig.3).

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Fig.1

Lateral radiograph of the knee demonstrates a fat-fluid level in a patient with a radiographically occult proximal tibia fracture.
Lipohaemarthrosis, Fig.1
Lipohaemarthrosis, Fig.2
Lipohaemarthrosis, Fig.3 (a)
Lipohaemarthrosis, Fig.3 (b)