A patient with a fracture of a knee bone And My Actifit Report Card: November 24 2018

I got this patient yesterday. Around 35 years old Bangladesh guy came on a wheelchair with swelling and severe pain in this left knee joint. He couldn't walk on foot without any assistance.

He gave a history of fall on his affected knee a few hours back while was at work. Following the fall, he could walk initially for a few hours but later, gradually the pain and swelling were increasing which rendered him disabled to walk alone.

I did X-ray of the left knee joint and found a fracture of the small bone called Patella (AKA kneecap). Later, I sent the patient to an orthopaedic doctor for further management.

Lesson for me:
The X-ray cost per film is 5 OMR (almost 13$). In most of the cases, we need X-ray in two planes or view such as Anterior-posterior (AP) view and Lateral view. Some patients ask why need two X-rays of a single joint and they hesitate or deny to give double money! This may be due to the high cost. Considering their financial abilities and depending upon the clinical condition, I also, sometimes, do only one view. But this time, I insisted to do both views as I suspected of having a fracture. Lucky me (obviously unlucky patient), my suspicion was correct. And If I would do only one view (normally AP view), I would have missed the fracture which would be a grave mistake!

You can see the X-ray film, right-sided one is the lateral view which shows the fracture of the small bone called patella. But in AP view, the fracture is not obvious.

So, we should try to follow the protocol written in the text books, always!

Image is taken by me from the X-ray view box.

10336

Aerobics, Daily Activity, Moving Around Office, Walking

Height

165 cm

Weight

75 kg

Body Fat

%

Waist

cm

Thighs

cm

Chest

cm