ChiroACCESS Article



Diagnostic Imaging Case Report: A 77-year-old female reports pain and swelling of the right knee



This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

Jack Henry, DC, DACBR

  

Radiology Diagnostics, LLC



Published on

May 19, 2010

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Hello. My name is Jack Henry, DC, DACBR. I am Radiologist-in-Chief of Radiology Diagnostics, LLC, an industry leader of Chiropractic Radiology Services and Digitized Spinographic analyses. All of our services are provided at no cost to doctor and no/low cost to patients.

Selected cases will be presented for your evaluation. The studies may or may not have abnormalities. Use the arrow keys or the scroll bar to carefully evaluate the films.

Step 1: Is the study abnormal or normal?

Step 2: If the study is abnormal, what is your best diagnosis?

Step 3: Which follow-up imaging option would be best?

Step 4: Compare your results with the correct diagnosis.

HISTORY


A 77-year-old female reports pain and swelling of the right knee.  The patient can not bear weight on the right knee.  No history of recent trauma was reported.  Physical exam was limited due to pain.
 





FINDINGS

Moderate to marked osteopenia is noted throughout the structures visualized.  Soft tissue swelling is present.  Mild marginal bony proliferation with joint space narrowing is present pan compartmentally.  Meniscal chrondrocalcinosis is noted within the medial and lateral compartments.  Most troubling is the lucent band noted transversing the supracondylar region.  In addition, there is subtle discontinuity of the cortex best seen on the lateral view.


DISCUSSION

The lesion noted represents an insufficiency fracture.  These fractures, if untreated, may progress with trivial trauma or further weight bearing.


FOLLOW UP PROTOCOL

No further imaging is necessary at this time.  Most patients respond to conservative treatment that must include an initial period of non-weight bearing followed by cautious introduction of a progressive rehab program.
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