Indians For Guns

An appeal to Asif and other doctors of this forum :--

I request Asif and other doctors on this form to please explain the extract from an MRI report.

The extract :--


Fracture of lateral tibial condyle with adjacent T2 & STIR hyperintensities----S/0 Marrow oedema/contusion.

IMPRESSION: MR IMAGE MORPHOLOGY IS IN FAVOUR OF FRACTURES OF THE LATERAL TIBIAL CONDYLE WITH
ADJACENT MARROW OEDEMA/CONTUSION

MODERATE SYNOVIAL EFFUSION-?HAEMARTHROSIS.

It would be sufficient if get to know 1) Is it a fracture of bone ? If yes, how serious ? 2) If not a fracture of bone, what is it ?

The reason I ask in this forum is internet search in throwing results in terms which only a doctor can understand and the doctor assigned to me is in OT and is not accesible before 8 PM tomorrow. After receiving the report I have lost my sleep unable to grasp the significane because the X ray did not show any fracture.

Many thanks in advance.

Sujay

Basketball or hi impact sports? and / or two wheeler accident??
YES-if it has taken an MRI to zero down AND there is marrow edema-I would call it a fracture! Its been a long time ago that I've switched from ortho to em med, but if there is a causative incident,pain, swelling, limited movement at that joint and x ray doubtful, thats why the mri was asked for!Looks like the fragment is hardly displaced,the surgeon may get away with insertion of a couple of cancellous screws-if in an adult.
The hemarthrosis or collection of blood OUT of the bone, in the joint cavity-a ' fracture hematoma' is another positive indicator.
would appreciate more details of patient (via pm)of the causative mechanism, if there was one e.g trauma, because a 'de novo 'fracture aka 'pathological fracture' is worrying...Hope this has been of help.

Many thank... PM on way..

the xray will only show a positive sign if there is displacement of bone pieces
lateral tibial condyle generally gets fractured due to impact or lateral torsion injuries,
haematherosis is a colateral finding
edema contusion are always there with a injury which has started to repair itself
there were no sol in the tibial condyle in mri so a pathological fracture is ruled out
generally this type of injury occurs say while stepping out of the car the ligaments cause a shearing stress on the bone.

Sujoy,

Orthopaedic Surgeon/Arthroscopist here.

This fracture is also known as the "bumper fracture".

I agree with Asif fully. Assuming it is a case of trauma, the report means a minimally displaced fracture of the lateral (outer) condyle of the proximal tibia. since this fracture is intra-articular ( with in the joint) there will be bleeding from the broken bone inside the joint cavity ( haemarthrosis). Bone bruise/contusion and marrow oedema are diagnoses seen only in the MRI images and a plain x-ray cannot pick it up.

Depending upon the comminution and displacement of the fractured fragments the treatment can be planned. A tense haemarthrosis can be aspirated. The fracture can be treated surgically or conservatively. Weight bearing in any case has to be avoided for 6 weeks approx. Early mobilisation of the knee joint is advisable.

best,
RP.

Your replies are greatly appreciated; Casual Shooter , The Doc and Asif.

After reading your replies', I realise that I have walked around (though minimally) with walker/stick, some damage has been done. But this was done as the X Ray did not reveal any fracture. I will now pray for the best. It was a two wheeler accident by the way on 14th Jan 2008. I have also applied ice and warmth extensively on knee and hope they have not cuased any harm

Thanks to you guys once again.



Sujay

Mend well and fast.

Sujay";p="37091 wrote:Your replies are greatly appreciated; Casual Shooter , The Doc and Asif.

After reading your replies', I realise that I have walked around (though minimally) with walker/stick, some damage has been done. But this was done as the X Ray did not reveal any fracture. I will now pray for the best. It was a two wheeler accident by the way on 14th Jan 2008. I have also applied ice and warmth extensively on knee and hope they have not cuased any harm

Thanks to you guys once again.

Sujay

Get well soon Sujay

Best,
Abhijeet

Sujay";p="37091 wrote: on 14th Jan 2008. I have also applied ice and warmth extensively on knee and hope they have not cuased any harm

Sujoy,
When was this MRI done? Its been 2 wks after injury. I understand that your Orthopaedist is treating you conservatively. If the MRI was done around 14thJan then It might be a good idea to get a check xray now. Sometimes the fracture line especially in the cancellous bone becomes visible after 10-14 days. Moreover, since you have indeed put some weight on it , it would be wise to see any depression/displacement of the lateral condyle.

best

RP.

Get well soon Sujay.
regards,
rk

Speedy recovery Sujay

Get well soon,,,

Thanks and lots of appreciation for your best wishes

Keep posting interesting stuff !

Get well soon Sujay...

-Inder

Get well soon Sujay. Take good care of yourself, I found that braving injuries just adds to recovery time and more misery and pain. Focus on recovery and it will happen faster and you'll be back in action sooner.

I wish you a speedy recovery.