Chapter 2: Distal Lower Limb

Introduction

The regions of the distal lower limb include:

• Popliteal fossa (knee joint)

• Anterior, posterior, and lateral leg

• Tarsal tunnel

• Sole and dorsum of the foot

• Plantar and dorsal toe

The clinician should be very familiar with lower limb anatomy as this constitutes a large proportion of all imaging and is often due to a greater force than the upper limb.

Injuries of the lower limb affect mobility, which can have disastrous consequences for some patients.

Normal Images

Knee Joint

Notes

Recurrent knee pain, joint locking, giving way and history of an old injury.

Report

Large corticated (old) loose body in the suprapatellar recess.

Treatment

Arthroscopic removal if not too big and check for secondary or associated joint pathology.

Notes

Major trauma. Check pulses!

Report

Tibia completely dislocated posteriorly on femur with displaced transverse patellar fracture.

Treatment

Urgent vascular assessment and reduction with ligament repair.

Notes

Major knee injury due to either fall from a height, motorcar accident, or other similar incident. Severe pain, swelling, deformity, and dysfunction.

Report

Fracture-dislocation of the knee (tibia laterally on femur). The lateral femoral condyle has been driven into the intercondylar area splitting the medial tibial condyle off and displacing it inferiorly.

Treatment

Open reduction and internal fixation. Check peripheral pulses.

Notes

Recurrent giving way, locking, loose bodies, or asymptomatic.

Report

Fragment in medial femoral condyle (Osteochondritis dissecans).