Lateral radiograph of the knee in a patient with sudden pain | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Lateral radiograph of the knee in a patient with sudden pain while jumping on a trampoline shows a comminuted avulsion fracture (arrow) of the tibial tuberosity. Tibial tuberosity avulsion fractures are caused by knee flexion against a tight contraction quadriceps. This type of injury represents the most second most common type of fracture related to trampolines. Check back next #MSKMonday to see the most common trampoline fracture. #MSKMonday #MusculoskeletalMonday

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AP (image 1) and lateral (image 2) radiographs of the knee in a child with sudden pain after jumping on the trampoline with a parent show a nondisplaced transverse fracture of the proximal tibia. This type of fracture is the most common fracture associated with trampolines. It is caused by tandem jumping. When a heavier jumper bounces up, the trampoline recoils. If the smaller child is coming down at the time when the trampoline recoils, the force of the recoil causes considerable axial loading on the tibia and causes a fracture. This mechanism is highlighted in a classic article by Boyer, et al. #MSKMonday #MusculoskeletalMonday

Knee x-ray shows an avulsion fracture (arrow) of the inferior pole of the patella and a large knee effusion. This type of avulsion fracture, called a patellar sleeve avulsion, is unique to children and occurs with forceful contraction of the quadriceps muscle against resistance. #MSKMonday

AP and lateral radiographs of the knee show a small avulsion fragment along the lateral aspect of the tibial epiphysis and a large knee effusion. This type of fracture represents an avulsion of the lateral collateral ligament and is known as a Segond fracture. It is important to recognize as it is almost always associated with an ACL injury. #MSKMonday

AP (image 1) and frog-leg (image 2) show avulsion fractures of the iliac crest extending to the right anterior superior iliac spine (arrow) and left ischial tuberosity (arrowhead). Avulsion fractures occur at the site of tendon insertion. The most common pelvic avulsion fracture is at the anterior superior iliac spine at the origin of the sartorius muscle. The hamstring muscles originate at the ischial tuberosity. #MSKMonday #MusculoskeletalMonday

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