Identifying malaligned knee screw during ultrasound examination

This case shows how ultrasound helped identify a malaligned surgical screw inside the lateral knee joint after osteotomy. In addition to detecting suprapatellar effusion, ultrasound visualized the metallic artifact within the joint space and linked it to the patient’s pain and limited motion. Its main clinical value was the ability to assess the hardware together with the surrounding soft tissues in real time, which supported the decision for revision surgery.

Interesting highlights:

• Ultrasound showed both joint effusion and the intra-articular metallic artifact.

• The findings matched the patient’s severe pain, swelling, and motion restriction.

• After revision surgery, ultrasound confirmed reduced effusion and disappearance of the metallic object from the joint view.

• The article highlights ultrasound as a useful option when assessment of soft tissues around postoperative hardware is needed.

Who is this article most useful for?
MSK ultrasound clinicians, PM&R physicians, orthopedic teams, pediatric rehabilitation specialists, and radiologists evaluating painful postoperative knees.