UMEM Educational Pearls

Title: Lipohemarthrosis

Category: Ultrasound

Keywords: POCUS; MSK; fracture (PubMed Search)

Posted: 3/17/2025 by Alexis Salerno, MD (Updated: 3/21/2025)
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On ultrasound, lipohemarthrosis—the presence of blood and fat in the joint cavity—is a key clinical indicator of an intra-articular fracture.  

Lipohemarthrosis appears as three distinct layers near the joint line.  

  • Superficial Layer- hyperechoic fat with circular anechoic fat globules 
  • Middle Layer- Anechoic Serum 
  • Deep Layer- Slightly hyperechoic, representing clotted blood 

References

Salerno A. Lipohemarthrosis. Floating fat in an intra-articular fracture. Visual Journal of Emergency Medicine. 2022, 26:101236.