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Radiology, Vol 198, 499-502, Copyright © 1996 by Radiological Society of North America

ARTICLES

Fluid-fluid levels in injured knees: do they always represent lipohemarthrosis?

CH Lugo-Olivieri, WW Scott Jr and EA Zerhouni
Russell H. Morgan Department of Radiology and Radiological Science, Johns-Hopkins Hospital, Baltimore, MD 21287, USA.

PURPOSE: To determine if fluid-fluid levels on horizontal-beam radiographs of posttraumatic knee joints always represent lipohemarthrosis. MATERIALS AND METHODS: The files of 41 patients with tibial plateau fracture were reviewed retrospectively. Twelve with fluid-fluid levels on radiographs who underwent computed tomography (CT) or magnetic resonance (MR) imaging were selected; CT attenuation and MR signal intensity patterns were used to assess fluid-fluid levels. Simulated hemarthrosis and lipohemarthrosis underwent plain radiography, CT, and MR imaging. RESULTS: Eight patients showed no evidence of fat in the supernatant fluid with either CT (n = 7) or CT and MR imaging (n = 1). Fluid levels resulted from blood separating into cellular elements and supernatant serum. Four patients showed evidence of lipohemarthrosis with either CT (n = 3) or MR imaging (n = 1); in one of these patients, a double fluid-fluid level could be demonstrated retrospectively on plain radiographs. CONCLUSION: Single fluid-fluid levels in posttraumatic knee joints do not necessarily represent a lipohemarthrosis. Double fluid-fluid levels are a more specific finding.


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 Am. J. Roentgenol.Home page
D. N. Costa, C. F. A. Cavalcanti, and R. A. Sernik
Sonographic and CT Findings in Lipohemarthrosis
Am. J. Roentgenol., April 1, 2007; 188(4): W389 - W389.
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