Comparison of X-ray, CT, MRI and ultrasonography in diagnosis of knee joint lipohemarthrosis / 中华全科医师杂志

Forty eight patients with knee joint lipohemarthrosis underwent X-ray, CT, MRI and ultrasonography examinations, the diagnosis was confirmed by knee operation or puncture.The findings of 4 imaging methods were compared.Plain radiographs displayed fracture lines in 39 cases and fat-liquid layer of suprapatellar bursa in 40 cases, it displayed suprapatellar fat-liquid layer in 5 out of 9 occult fracture cases.CT displayed fracture lines in 48 cases and joint lipohemarthrosis in 48 cases; 3D imaging showed fracture lines better.MRI displayed fracture lines in 45 cases and joints lipohemarthrosis in 48 cases, and also showed the intracapsular structure injury.Ultrasonography revealed fracture lines in 15 cases and joint lipohemarthrosis in 48 cases, lipohemarthrosis was displayed in 7 out of 9 occult fracture cases.All 4 diagnostic imaging methods have advantages and disadvantages for diagnosis of lipohemarthrosis, and should be chosen on the basis of clinical needs.

Observation on the optimal brakingtime for ultrasonography of traumatic lipohemarthosis / 中华超声影像学杂志

Objective To investigate the braking time in diagnosis of lipohemarthrosis by ultrasound. Methods Experiment group:After 20 tubes containing fresh blood and pig marrow were uniformly mixed, they were instantly continuously detected by high-frequency linear array transducer in fixed-area at short-interval.Clinical group: Ten walking patients with lipohemarthrosis were examined with continuous detection by ultrasound,CT and MR before operation.Results Experiment group: Cloudy echo and slowly floating up of lipoids were detected at the beginning.After 2.7 to 3.7 minutes (average 3.17 minutes), the liquid was divided into two layers with vague boundary.After 5.3 to 8.0 minutes (average 6.75 minutes) ,the liquid was divided into 3 layers with thickening serum laye.Clinical group: Ultrasound findings: Cloudy medium echo was detected at first.After 2.0 to 4.0 minutes (average 3.08 minutes),the liquid was divided into two layers.After 4.4 to 10.0 minutes (average 6.92 minutes) , the liquid was divided into 3 layers with thickening serum layers.Three knees showed fracture line and 2 knees with occult fracture were diagnosed as lipohemarthrosis.CT and MR findings: Ten knees showed fracture line in CT examination,of which 7 knees showed double liquid-liquid layer and 3 knees showed single liquid-liquid layer in the suprapatellar bursa.Ten knees showed fracture line in MR examination,6 knees showed double liquid-liquid layer and 4 knees showed single liquid-liquid layer in the suprapatellar bursa. Conclusions The best braking time in diagnosing lipohemarthrosis by ultrasound can be shorten to 10 minutes and the necessary braking time is 2 to 4 minutes.

Correlation between ultrasonography and relevant techniques in traumatic lipohemarthrosis / 中国医学影像技术

Objective To explore the correlation between ultrasonographic findings and relevant technical factors in traumatic lipohemarthrosis. Methods Fifty-two patients with traumatic lipohemarthrosis underwent ultrasonic examination in supine position (26 in unbent, 16 in external rotary position, 10 in unbent and 45° rotation) before operation, and 22 of them underwent dynamic examination. Findings of ultrasography were compared with manifestations of MRI and CT regarded as gold standard.Results Fifty-two patients with traumatic lipohemarthrosis were diagnosed correctly. The best effect of ultrasonic examination of lipohemarthrosis was observed on suprapatellar bursa. Superior border of patella were showed well in supine straight position, then turned to the level of patella, and the structure below patella were showed badly. The best posture was in supine genuflex position with 45° rotation when the joint effusion presented, by which thicker layer liquids could be displayed than in straight position. Three layer liquids could not be displayed synchronously in mild external rotary rest position of lower extremity, and the combination of findings at internal and external side were favorable to the diagnosis. Liquids bed changed from one layer to two layers and then to three layers, from fuzzy to clear gradually in dynamic examination.Conclusion Ultrasonic manifestations of traumatic lipohemarthrosis are closely correlated to the position, posture and arresting time during examination.