Case 45 History: trauma
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Case 45 Answer: Segond Fracture.
Yes this one is HUGE ( this is the most obvious finding on the image I gave you - see full notes below)
Segond Fracture is a fracture of the lateral aspect of the tibial plateau, famous for it’s association with internal knee soft tissue injury (ACL tears of ~75%, with less frequent association with meniscal injuries).
Don’t get it confused with an avulsive fracture of the fibular head - ie the “arcuate sign” which is associated with posterolateral corner injuries
BUT WAIT, check out the lateral closely - this case has BOTH (see below) and I do think you can make both out on the AP as well.
Red arrow = Segond fracture
Yellow arrow = fibular head avulsion fracture (ie “arcuate sign”)
Segond fracture: http://radiopaedia.org/articles/segond-fracture
more detail: http://radiographics.rsna.org/content/28/6/1755.full
Arcuate sign: http://radiology.rsna.org/content/244/2/620.full
Time for a short break and we’ll get started again with the new academic year in July.
Best of luck to all the 4th years with the oral boards. You will all do GREAT! Pretty soon it will all be over and your real life can truly begin!
To everyone else, have a terrific summer and keep up the good work.