Tibial plateau fracture diagnostic study of choice

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

Computed tomography (CT) is the gold standard test for the diagnosis of tibial plateau fracture. Computed tomography (CT) with two-dimensional reconstruction in the sagittal and coronal planes provides more detailed information than radiographs. CT is important to identify articular depression and comminution. CT also helps in fracture fragment orientation and surgical planning.

Diagnostic Study of Choice

Study of choice

Computed tomography (CT) is the gold standard test for the diagnosis of tibial plateau fracture.^[1]

Diagnostic results

The following findings on performing computed tomography (CT) are confirmatory for tibial plateau fracture:^[1]^[2]^[3]

CT confirms x ray findings.
CT is important to identify articular depression and comminution.
Presence of lipohemarthrosis indicates an occult fracture.
In addition, CT also helps in fracture fragment orientation.

Sequence of Diagnostic Studies

The various investigations must be performed in the following order:^[1]

X-rays of the Knee
CT scan of the Knee
MRI of the knee

Name of Diagnostic Criteria

There are no established criteria for the diagnosis of tibial plateau fracture.

CT scan coronal Tibia coronal view with intra articular commintuin. Source: Case courtesy by: Dr. Rohan A. Bhimani

CT scan Tibia AP view. Source: Case courtesy by: Dr. Rohan A. Bhimani

References

↑ ^1.0 ^1.1 ^1.2 Kode L, Lieberman JM, Motta AO, Wilber JH, Vasen A, Yagan R (1994). “Evaluation of tibial plateau fractures: efficacy of MR imaging compared with CT”. AJR Am J Roentgenol. 163 (1): 141–7. doi:10.2214/ajr.163.1.8010201. PMID 8010201.
↑ Rockwood, Charles (2010). Rockwood and Green’s fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
↑ Markhardt BK, Gross JM, Monu JU (2009). “Schatzker classification of tibial plateau fractures: use of CT and MR imaging improves assessment”. Radiographics. 29 (2): 585–97. doi:10.1148/rg.292085078. PMID 19325067.

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[pmid8010201-1] 1.0 ^1.1 ^1.2 Kode L, Lieberman JM, Motta AO, Wilber JH, Vasen A, Yagan R (1994). “Evaluation of tibial plateau fractures: efficacy of MR imaging compared with CT”. AJR Am J Roentgenol. 163 (1): 141–7. doi:10.2214/ajr.163.1.8010201. PMID 8010201.

[2] Rockwood, Charles (2010). Rockwood and Green’s fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.

[pmid19325067-3] Markhardt BK, Gross JM, Monu JU (2009). “Schatzker classification of tibial plateau fractures: use of CT and MR imaging improves assessment”. Radiographics. 29 (2): 585–97. doi:10.1148/rg.292085078. PMID 19325067.

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