Sunday, January 20, 2008

Loose Bodies in the Knee

"Seek and ye shall find."

Although this phrase is abstracted from religious discourse, it applies to loose bodies as well.

Loose bodies gather in characteristic places in joints, including the knee. Common locations are the suprapatellar pouch, the posterior intercondylar notch, and the medial and lateral gutters. One should always look in the popliteus hiatus as well.

Here is an example of a 35 year-old patient with a history of a failed osteochondritis dissecans repair. Coronal proton-density weighted image demonstrates breakdown of OCD repair of the medial femoral condyle:






Here are the resulting loose bodies in the lateral gutter:





And the suprapatellar pouch:



And the popliteus hiatus; yellow arrows denote the popliteus tendon:



It's a good idea to look for loose bodies carefully, with special attention to areas where they characteristically gather, including the popliteus hiatus.

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