MSK imaging: lipohaemarthrosis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · MSK imaging: lipohaemarthrosis

Sample item

After a fall, a patient has a swollen knee and a normal-looking anteroposterior film. A horizontal-beam lateral view shows a fat-fluid level in the suprapatellar pouch. What does this indicate?

AA Baker cyst ruptureBGouty arthritisCA simple joint effusion from synovitisDAn intra-articular fracture with marrow fat released into the joint

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. An intra-articular fracture with marrow fat released into the joint

Fat from marrow floats above blood in the joint, forming a fat-fluid level seen only on a horizontal-beam film. It implies an intra-articular fracture even when none is visible, so CT or MRI may be needed. Simple effusions contain no fat layer.

Option by option

A. A Baker cyst rupture
A Baker cyst lies in the popliteal fossa and is not the cause here.
B. Gouty arthritis
Gout does not release marrow fat into the joint.
C. A simple joint effusion from synovitis
A synovial effusion has no fat-fluid level.
D. An intra-articular fracture with marrow fat released into the joint (correct)
Correct. A fat-fluid level signals an occult intra-articular fracture.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, An intra-articular fracture with marrow fat released into the joint. Fat from marrow floats above blood in the joint, forming a fat-fluid level seen only on a horizontal-beam film.

Why is "A Baker cyst rupture" not the answer?

A Baker cyst lies in the popliteal fossa and is not the cause here.

Why is "Gouty arthritis" not the answer?

Gout does not release marrow fat into the joint.

Why is "A simple joint effusion from synovitis" not the answer?

A synovial effusion has no fat-fluid level.

What concept does this question test?

It tests MSK imaging: lipohaemarthrosis in Radiology. It implies an intra-articular fracture even when none is visible, so CT or MRI may be needed. Simple effusions contain no fat layer.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study MSK imaging: lipohaemarthrosis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.