LOOSE BODIES IN KNEE

Loose bodies in knee are not very rare. Depending on age, activity level and etiology, they can be of various types.
The loose bodies are classified into following type:

Osteocartilaginous
1) Osteochondral fractures
2) Osteophytes.

Cartilaginous
Cartilaginous loose bodies are usually traumatic Arising from articular surfaces. They can also be of following types.
1) Osteochondritis dessicans
2) Synovial chondromatosis

Fibrous
Fibrous loose bodies arise due to hyalinisation of synovium due to trauma or inflammation e.g. rice bodies in TB

Miscellaneous
1) Lipoma
2) Nodular sinovitis
3) Foreign bodies : Bullets, needles or broken instruments

Clinical features
Pain, swelling and locking episodes are common. There might be features specific to individual entity.
Some of loose bodies can be felt. Often ,there is synovial thickening.

Investigations
Plain x-rays does show radio opaque loose bodies. Ultrasound can shoe synovial swelling and effusion, in addition to radiolucent loose body.
MRI is the best investigation to see intraarticular pathology.

Management
Symptomatic loose bodies should be removed. Removal can be done either open or arthroscopic.