Radiology Review

Driver Partially Ejected From Vehicle

Author and Disclosure Information

He wasn't wearing a seatbelt when his truck went into a ditch; his leg was caught in the window.

What is the extent of his injuries?


A 28-year-old man is brought to your facility by EMS for evaluation status post a motor vehicle accident. The patient was an unrestrained driver in a truck that went off the road into a ditch. The paramedics state that he was partially ejected, with his left leg caught in the window. There was brief loss of consciousness. Upon arrival, he is awake and alert, with a Glasgow Coma Scale score of 15. His primary complaints are of back and left leg pain. His medical history is unremarkable, and vital signs are stable. Primary survey shows no obvious injury. Secondary survey reveals moderate swelling and decreased range of motion in the left knee. Good distal pulses are present. As part of your orders, you request a portable radiograph of the left knee. What is your impression?


 

References

ANSWER
The radiograph shows that the distal femur is medially dislocated relative to the tibial plateau. In addition, the patella is laterally dislocated. No obvious fractures are evident.

Such injuries are typically associated with significant ligament injuries, especially of the medial collateral ligament (MCL), lateral collateral ligament (LCL), and anterior cruciate ligament (ACL). Orthopedics was consulted for reduction of the dislocation, as well as further workup (including MRI of the knee).

Recommended Reading

An Incidental Finding During Neuro Evaluation
Clinician Reviews
Case Studies in Toxicology: Double Take—Is Re-exposure Necessary to Explain Delayed Recurrent Opioid Toxicity?
Clinician Reviews
Postoperative Patient Suddenly Worsens
Clinician Reviews
A Not-So-Old Football Injury
Clinician Reviews
Seizure Prompts Man to Fall
Clinician Reviews
Mind the Gap: Case Study in Toxicology
Clinician Reviews
Girl, 5, With Fever and Hip Pain
Clinician Reviews
Woman Complains of Knee Pain Following Fight
Clinician Reviews
Case Studies in Toxicology: Babies and Booze—Pediatric Considerations in the Management of Ethanol Intoxication
Clinician Reviews
Case Studies in Toxicology: When Doing More for the Sake of Better Health Goes Wrong
Clinician Reviews

Related Articles

  • Radiology Review

    Seizure Prompts Man to Fall

    A 70-year-old man is brought to your facility by EMS following a new-onset, witnessed seizure. He reportedly fell down some steps. On arrival, he...

  • Radiology Review

    A Not-So-Old Football Injury

    A 15-year-old boy presents for evaluation of left wrist pain. He says that two days ago, while playing football, he fell onto his outstretched...