Acute knee trauma: analysis of multidetector computed tomography findings and comparison with conventional radiography

Mustonen, A. O. T.; Koskinen, S. K.; Kiuru, M. J.
December 2005
Acta Radiologica;Dec2005, Vol. 46 Issue 8, p866
Academic Journal
journal article
Purpose: To evaluate the multidetector computed tomography (MDCT) findings of acute knee trauma and to compare radiography with MDCT in patients referred to a level 1 trauma center. Material and Methods: During a 5-year period, a total of 415 MDCT examinations were performed on 409 patients with acute knee trauma to reveal complex fracture anatomy or rule out a fracture. MDCT and primary radiographs were re-evaluated with respect to fracture location and trauma mechanism. Tibial plateau fractures were further analyzed depending on anatomical location: anterior-medial, anterior-lateral, posterior-lateral, and posterior-medial regions. Maximal depression of the tibial articular surface was measured. Findings on the primary knee radiographs were compared with MDCT findings. Results: Of the 409 patients, 356 (87%) had a knee fracture. A total of 451 fractures were found in all anatomic regions: distal femur (n=49), proximal tibia (n=307), patella (n=23), and proximal fibula (n=72). Primary radiographs were available in 316 (76%) cases. Of these, 225 (71%) had MDCT in order to reveal the fracture anatomy better, and 91 (29%) had a subsequent MDCT after negative plain radiographs. Overall sensitivity of radiography was 83%, while negative predictive value was 49%. On radiography, tibial plateau articular depression was underestimated in all regions except when the fracture consisted of the whole half of the anterior or posterior plateau. The three main injury mechanisms were traffic accident, a simple fall, and sport. In 49 cases (15%), primary radiographs were suboptimal due to positioning. Conclusion: In severely injured patients, diagnostically sufficient radiographs are difficult to obtain, and therefore a negative radiograph is not reliable in ruling out a fracture. In these patients, MDCT is a fast and accurate examination and is also recommended in patients with tibial plateau fractures or complex knee injuries in order to evaluate the fracture adequately.


Related Articles

  • X-rays for knee injuries. E.B. // Medical Update;Jun96, Vol. 19 Issue 12, p2 

    Reports that a group of Canadian researchers has developed guidelines that identified 100 percent of knee fractures before an x-ray was taken. Patient conditions that require x-rays; Soft tissue injury as the finding in the vast majority of patients.

  • Ottawa knee rules validated. Hasan, Benjamin A. // Physician & Sportsmedicine;Aug99, Vol. 27 Issue 8, p27 

    Discusses the research ` External Validation of the Ottawa Knee Rules in an Urban Trauma Center in the United States,' by S. Tigges, S. Pitts, S. Mukudan Jr. et al, published in a 1999 issue of the `American Journal of Radiology.' Sensitivity of Ottawa knee rules to fracture; Presence and...

  • A 12-year-old boy with a right knee injury. Chalmers, Peter N.; Al-Shihabi, Laith; Ferry, Scott T. // Orthopedics Today;Jul2014, Vol. 34 Issue 7, p42 

    The article describes the case of a patient diagnosed with extensor mechanism disruption with a combined tibial tubercle avulsion fracture and partial patellar tendon avulsion and the management used to treat his condition.

  • The value of a CT scan compared to plain radiographs for the classification and treatment plan in tibial plateau fractures. Stroet, Martijn; Holla, Micha; Biert, Jan; Kampen, Albert // Emergency Radiology;Aug2011, Vol. 18 Issue 4, p279 

    This study aimed to evaluate the intra- and interobserver agreement for both fracture classification according to Schatzker and treatment plan of tibial plateau fractures using plain radiographs alone and with computed tomography (CT) scans. The study was carried out prospectively to assess the...

  • Tibial Plateau Fracture Characteristics: Computed Tomography Mapping of Lateral, Medial, and Bicondylar Fractures. Molenaars, Rik J.; Mellema, Jos J.; Doornberg, Job N.; Kloen, Peter // Journal of Bone & Joint Surgery, American Volume;9/16/2015, Vol. 97 Issue 18, p1512 

    Background: Computed tomography (CT) is seen as a useful diagnostic modality in preoperative planning for tibial plateau fractures. The purpose of this study was to characterize patterns of tibial plateau fractures with use of CT mapping. We hypothesized that CT mapping of fractures...

  • Volumetric quantitative computed tomography of the proximal femur: relationships linking geometric and densitometric variables to bone strength. Role for compact bone. Bousson, V.; Le Bras, A.; Roqueplan, F.; Kang, Y.; Mitton, D.; Kolta, S.; Bergot, C.; Skalli, W.; Vicaut, E.; Kalender, W.; Engelke, K.; Laredo, J.-D. // Osteoporosis International;Jun2006, Vol. 17 Issue 6, p855 

    Introduction: In assessing cervical fractures of the proximal femur, this in vitro quantitative computed tomography (QCT) study had three objectives: to compare QCT to dual-energy X-ray absorptiometry (DXA) for predicting the failure load of the proximal femur, to compare the contributions of...

  • Medial condyle fracture of the distal humerus in an adolescent with pre-existing fishtail deformity. A case report. Namba, Jiro; Tsujimoto, Takashi; Temporin, Ko; Yamamoto, Koji // Emergency Radiology;Dec2011, Vol. 18 Issue 6, p507 

    Medial condyle fractures of the humerus are rare in any age group. We report a unique case of a humeral medial condyle fracture in a 15-year-old boy with posttraumatic fishtail deformity. The fracture line extended up from the top of the sharp trochlear wedge to the incomplete medial...

  • Traumatic injuries: imaging of pelvic fractures. Theumann, N.; Verdon, J.; Mouhsine, E.; Denys, A.; Schnyder, P.; Portier, F. // European Radiology;Jun2002, Vol. 12 Issue 6, p1312 

    Pelvic trauma includes a great variety of very polymorphous lesions, differing from each other by their anatomical aspect, their context and therapeutic implication: In order to be efficient, the radiologist first has to know diagnostic value of each radiological technique, in order to suggest...

  • The clinical significance of 18F-FDG-PET/CT in early detection of second primary malignancy in cancer patients. Haoping Xu; Miao Zhang; Ge Zhai; Biao Li // Journal of Cancer Research & Clinical Oncology;Aug2010, Vol. 136 Issue 8, p1125 

    This retrospective study evaluated the diagnostic value of integrated whole-body 18F-fluorodeoxyglucose positron-emission tomography and computed tomography (18F-FDG-PET/CT) in early detection of second primary malignancies in cancer patients. From June 2007 to October 2008, 677 cancer patients...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics