Therapeutic Embolization for Spontaneous Recurrent Hemarthrosis of the Knee in the Elderly

Kwang-Won Lee; Youngdong Song; Dae Geon Song; Won Sik Choy

doi:10.4055/jkoa.2014.49.6.480

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Lee, Song, Song, and Choy: Therapeutic Embolization for Spontaneous Recurrent Hemarthrosis of the Knee in the Elderly

Case Report

Journal of the Korean Orthopaedic Association 2014; 49(6): 480-484.

Published online: 30 December 2014

DOI: https://doi.org/10.4055/jkoa.2014.49.6.480

Therapeutic Embolization for Spontaneous Recurrent Hemarthrosis of the Knee in the Elderly

Kwang-Won Lee, M.D., Youngdong Song, M.D.^*, Dae Geon Song, M.D., Won Sik Choy, M.D.

Department of Orthopedic Surgery, Eulji University Hospital, Daejeon, Korea.

^*Department of Physical Examination, Korea Military Administration, Daejeon, Korea.

Correspondence to: Youngdong Song, M.D. Department of Physical Examination, Korea Military Administration, 189 Cheongsa-ro, Seo-gu, Daejeon 302-701, Korea. TEL: +82-42-481-2938, FAX: +82-42-481-2949, osdryd@gmail.com

Received 2 January 2014 Revised 23 April 2014 Accepted 24 April 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Without traumatic history, spontaneous hemarthrosis of the knee is a relatively rare condition, and there is no report of the diagnosis and treatments in Korea. In this case, magnetic resonance imaging and arthroscopic findings showed hemarthrosis and a lateral meniscus tear. Hemarthrosis of the patient remained after meniscus resection and coagulation; we then, found rupture of the lateral geniculate artery by computed tomography-angiography. We report on a case of successful treatment of spontaneous hemarthrosis with therapeutic embolization with a thorough review of the relevant literatures.

Keywords: hemarthrosis, therapeutic embolization, lateral menisci

Figures and Tables

Figure 1

Plain radiograph showed asymmetric joint space narrowing (lateral side) of the left knee.

Figure 2

Magnetic resonance imaging showed hemarthrosis with increased suprapatellar fluid collection and air-fluid level and showed a bucket-handle type tear of the lateral meniscus with empty space in the lateral femorotibial joint space. (A) Sagittal plane. (B) Coronal plane.

Figure 3

(A) On arthroscopic finding, there was degenerative change in the lateral compartment and a bucket-handle tear was observed on the lateral meniscus and no abnormal finding of synovium. (B) Partial meniscectomy and coagulation was performed.

Figure 4

CT angiography showed contrast leakage on posterior and hemarthrosis of the left knee.

Figure 5

(A) Active bleeding and hypervascularity (arrow) were seen in intervention radiography. (B) After embolization, there was a significant reduction (arrow) in abnormal vascularity.

References

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