US Knee US would not be the next best imaging study to evaluate for radiographically occult fractures and/or internal derangement of the acutely injured knee. However, US may demonstrate a lipohemarthrosis, indicating the presence of an intra-articular fracture [40]. US is an excellent imaging modality for the diagnosis of quadriceps tendon tears [42] with good performance in the evaluation of the meniscal [44-46] and ligamentous [47-49] injuries. However, the utility of US in the evaluation of the knee menisci, cruciate and collateral ligaments, and periarticular soft tissues varies depending on patient factors. Variant 5: Adult or child 5 years of age or older. Fall or acute twisting trauma to the knee. Tibial plateau fracture on radiographs. Suspect additional bone or soft-tissue injury. Next study. CT Knee In patients with radiographic diagnosis of the tibial plateau fracture, CT is frequently performed for further classification and characterization of the fracture severity [12,52] and may predict or diagnose ligamentous injuries [13-15,50,51] and predict meniscal injuries [15,50]. A study by Spiro et al [50] found that the amount of articular surface depression on CT is a predictor of meniscal and ligamentous injuries and can suggest when an MRI is indicated to confirm or exclude meniscal and ligamentous injuries [50]. In a study by Mustonen et al [12], CT showed 100% sensitivity and radiographs 83% sensitivity in detection of tibial plateau fractures, and CT was superior in further characterization of fracture severity. Chang et al [52] reported that CT-reconstructed images Acute Trauma to the Knee enhance the morphological subclassification of the medial tibial plateau fractures (Schatzker type IV) with common involvement of posterolateral quadrants. In the setting of acute knee trauma, Mui et al [13] reported 80% sensitivity and 98% specificity of the CT examination in detecting bony avulsion fractures.
Acute Trauma to the Knee. US Knee US would not be the next best imaging study to evaluate for radiographically occult fractures and/or internal derangement of the acutely injured knee. However, US may demonstrate a lipohemarthrosis, indicating the presence of an intra-articular fracture [40]. US is an excellent imaging modality for the diagnosis of quadriceps tendon tears [42] with good performance in the evaluation of the meniscal [44-46] and ligamentous [47-49] injuries. However, the utility of US in the evaluation of the knee menisci, cruciate and collateral ligaments, and periarticular soft tissues varies depending on patient factors. Variant 5: Adult or child 5 years of age or older. Fall or acute twisting trauma to the knee. Tibial plateau fracture on radiographs. Suspect additional bone or soft-tissue injury. Next study. CT Knee In patients with radiographic diagnosis of the tibial plateau fracture, CT is frequently performed for further classification and characterization of the fracture severity [12,52] and may predict or diagnose ligamentous injuries [13-15,50,51] and predict meniscal injuries [15,50]. A study by Spiro et al [50] found that the amount of articular surface depression on CT is a predictor of meniscal and ligamentous injuries and can suggest when an MRI is indicated to confirm or exclude meniscal and ligamentous injuries [50]. In a study by Mustonen et al [12], CT showed 100% sensitivity and radiographs 83% sensitivity in detection of tibial plateau fractures, and CT was superior in further characterization of fracture severity. Chang et al [52] reported that CT-reconstructed images Acute Trauma to the Knee enhance the morphological subclassification of the medial tibial plateau fractures (Schatzker type IV) with common involvement of posterolateral quadrants. In the setting of acute knee trauma, Mui et al [13] reported 80% sensitivity and 98% specificity of the CT examination in detecting bony avulsion fractures.