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
2. A 20-year-old man presents after his car was broadsided by another vehicle. His air bag deployed, and the patient now complains of right-sided chest wall pain and right knee pain. Inspection of his right knee shows some joint deformity, with mild swelling and moderate tenderness. The patient is unable to perform flexion with his right knee. Good distal pulses are present, and sensation is intact.
Diagnosis: The radiograph demonstrates lateral dislocation of the patella, with no evidence of an acute fracture in any surrounding bones. The patella was easily reduced in the emergency department, and the patient was placed in a knee immobilizer. Orthopedic consultation was obtained.
For more information, see “Chest Wall and Knee Pain Following Motor Vehicle Collision.” Clinician Reviews. 2013;23(1):8.
