2024 Friday Quiz 34 Answer | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

2024 Friday Quiz 34 Answer

Coronal (image 1), sagittal (image 2), and 3D reformatted (image 3) CT along with sagittal proton density MRI (image 4) highlight multiple injuries: an avulsion fracture (dashed arrow) of the lateral tibia epiphysis, an avulsion fracture of the tibial spine (arrow), and a large hemarthrosis (arrowhead). Both the fracture of the lateral tibia epiphysis and the tibial spine avulsion fracture are associated with ACL (orange arrow) rupture. The fracture of the lateral tibia epiphysis is termed a Segond fracture. In the majority of instances, Segond fractures are associated with ACL disruption. They occur as a result of internal rotation and varus stress. When the finding is made on radiograph, an MRI is typically indicated to assess for internal derangement of the knee. CT is not typically indicated. In this case, due to the extent of injury, CT was used to assess for loose bodies within the knee. The intact PCL (pink arrow) highlighted for comparison.