Extracapsluar lipohaemarthrosis: A case report and review of literature

Abstract

In the setting of trauma, occurrence of intracapsular lipo-hemarthrosis is not uncommon, highly useful and well known imaging finding. Occurrence of extracapsular lipohaemarthrosis is uncommon and have been noticed around the large joints like knee, hip, and shoulder joints. Extracapsular lipohaemarthrosis is rare especially around small joints like wrist joint. A 20-year-old male presented to emergency outpatient department following a fall on an outstretched hand, reported with subsequent pain, swelling, and restricted movement at the wrist joint. Imaging revealed a mildly displaced oblique fracture at the distal end of the radius with extension into the articular surface of the inferior radio-ulnar articulation. Additionally, fat-fluid level was observed around the extensor tendon at the wrist joint level, indicative of extra capsular lipo-hemarthrosis. Presence of fat fluid level around the joint, intra capsular or extra capsular should raise the suspicion of underlying fracture.

Keywords: Distal radius fractures; Lipohemarthrosis; Soft tissue injuries; Tendon injuries; Trauma; Wrist.

Fig. 1

Wrist radiograph of AP and Lateral view reveal minimally displaced fracture at the distal end of radius.

Fig. 2

Sag CT images in bone window depict of fat fluid level (Curved arrow) around the extensor digitorum longus tendon and displaced oblique fracture of distal end of radius (Linear arrow).

Fig. 3

CT axial image soft tissue window shows evidence of fat fluid level (Arrow) around the extensor digitorum longus tendon for second, third, fourth fingers (Curved arrow).